Provider Demographics
NPI:1275517187
Name:SCHREIBER CENTER FOR PEDIATRIC DEVELOPMENT
Entity Type:Organization
Organization Name:SCHREIBER CENTER FOR PEDIATRIC DEVELOPMENT
Other - Org Name:SCHREIBER PEDIATRIC REHAB CENTER OF LANCASTER COUNTY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:DEBORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-393-0425
Mailing Address - Street 1:625 COMMUNITY WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2301
Mailing Address - Country:US
Mailing Address - Phone:717-393-0425
Mailing Address - Fax:717-735-6009
Practice Address - Street 1:625 COMMUNITY WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2301
Practice Address - Country:US
Practice Address - Phone:717-393-0425
Practice Address - Fax:717-735-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000022960005Medicaid
PA1000022960004Medicaid
PA1000022960009Medicaid
PA1000022960008Medicaid