Provider Demographics
NPI:1003323205
Name:DALY CARE ASSOC.
Entity Type:Organization
Organization Name:DALY CARE ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-364-2262
Mailing Address - Street 1:88 CENTER CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3002
Mailing Address - Country:US
Mailing Address - Phone:412-364-2262
Mailing Address - Fax:
Practice Address - Street 1:88 CENTER CHURCH RD
Practice Address - Street 2:
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3002
Practice Address - Country:US
Practice Address - Phone:412-364-2262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16173601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102207757Medicaid