Provider Demographics
NPI:1083743678
Name:PIONEER HOUSE
Entity Type:Organization
Organization Name:PIONEER HOUSE
Other - Org Name:RHD
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-951-0300
Mailing Address - Street 1:413 SALEM CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1452
Mailing Address - Country:US
Mailing Address - Phone:302-286-0892
Mailing Address - Fax:
Practice Address - Street 1:413 SALEM CHURCH RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1452
Practice Address - Country:US
Practice Address - Phone:302-286-0892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2034320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities