Provider Demographics
NPI:1407429970
Name:HOME AWAY FROM HOME ADULT DAY CENTER INC
Entity Type:Organization
Organization Name:HOME AWAY FROM HOME ADULT DAY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-442-8370
Mailing Address - Street 1:1211 N PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1204
Mailing Address - Country:US
Mailing Address - Phone:484-442-8370
Mailing Address - Fax:610-200-1234
Practice Address - Street 1:1211 N PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1204
Practice Address - Country:US
Practice Address - Phone:484-442-8370
Practice Address - Fax:610-200-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care