Provider Demographics
NPI:1275833006
Name:TOWER HEALTH AT HOME - POTTSTOWN
Entity Type:Organization
Organization Name:TOWER HEALTH AT HOME - POTTSTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNANN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:DECUSATIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:610-378-0481
Mailing Address - Street 1:1170 BERKSHIRE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:610-378-0481
Mailing Address - Fax:610-378-9762
Practice Address - Street 1:1963 E. HIGH STREET
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464
Practice Address - Country:US
Practice Address - Phone:610-327-5700
Practice Address - Fax:610-327-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CLIA 39D0204552291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007496750003Medicaid
PA1007496750003Medicaid