Provider Demographics
NPI:1821724980
Name:PHOENIX REHABILITATION AND HEALTH SERVICES OF DELAWARE INC
Entity Type:Organization
Organization Name:PHOENIX REHABILITATION AND HEALTH SERVICES OF DELAWARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:METAL-CONFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-584-5739
Mailing Address - Street 1:2000 WESTINGHOUSE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5238
Mailing Address - Country:US
Mailing Address - Phone:412-567-2400
Mailing Address - Fax:
Practice Address - Street 1:1320 MIDDLEFORD RD STE 203
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3649
Practice Address - Country:US
Practice Address - Phone:302-404-5613
Practice Address - Fax:302-404-5616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty