Provider Demographics
NPI:1881023638
Name:PHOEBE CORPORATE & COMMUNITY BASED SERVICES
Entity Type:Organization
Organization Name:PHOEBE CORPORATE & COMMUNITY BASED SERVICES
Other - Org Name:CENTER FOR EXCELLENCE IN DEMENTIA CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:R
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-794-5142
Mailing Address - Street 1:1925 TURNER ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104
Mailing Address - Country:US
Mailing Address - Phone:610-794-5141
Mailing Address - Fax:610-794-5421
Practice Address - Street 1:1925 TURNER ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104
Practice Address - Country:US
Practice Address - Phone:610-794-5141
Practice Address - Fax:610-794-5421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHOEBE CORPORATE AND COMMUNITY BASED SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation