Provider Demographics
NPI:1629526728
Name:DACHA CORP.
Entity Type:Organization
Organization Name:DACHA CORP.
Other - Org Name:DACHA ADULT DAYCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:STATTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-967-6801
Mailing Address - Street 1:250 GEIGER RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-1008
Mailing Address - Country:US
Mailing Address - Phone:215-677-7707
Mailing Address - Fax:215-677-7708
Practice Address - Street 1:250 GEIGER RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1008
Practice Address - Country:US
Practice Address - Phone:215-677-7707
Practice Address - Fax:215-677-7708
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADULT CARE ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-17
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA313340261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018622260002Medicaid