Provider Demographics
NPI:1336650613
Name:COUNTY OF DELAWARE
Entity Type:Organization
Organization Name:COUNTY OF DELAWARE
Other - Org Name:COUNTY OF DELAWARE SERVICES FOR THE AGING
Other - Org Type:Other Name
Authorized Official - Title/Position:COSA DEPUTY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-490-1854
Mailing Address - Street 1:206 EDDYSTONE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:EDDYSTONE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1514
Mailing Address - Country:US
Mailing Address - Phone:610-490-1300
Mailing Address - Fax:610-490-1500
Practice Address - Street 1:206 EDDYSTONE AVE FL 2
Practice Address - Street 2:
Practice Address - City:EDDYSTONE
Practice Address - State:PA
Practice Address - Zip Code:19022-1514
Practice Address - Country:US
Practice Address - Phone:610-490-1300
Practice Address - Fax:610-490-1500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF DELAWARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management