Provider Demographics
NPI:1922068725
Name:FAMILY & COMMUNITY SERVICE OF DELAWARE COUNTY
Entity Type:Organization
Organization Name:FAMILY & COMMUNITY SERVICE OF DELAWARE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-566-7540
Mailing Address - Street 1:600 N OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2418
Mailing Address - Country:US
Mailing Address - Phone:610-566-7540
Mailing Address - Fax:610-566-7677
Practice Address - Street 1:600 N OLIVE ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2418
Practice Address - Country:US
Practice Address - Phone:610-566-7540
Practice Address - Fax:610-566-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA100777606104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA188753000Medicaid