Provider Demographics
NPI:1992212906
Name:DELTA COMMUNITY SUPPORTS, INC.
Entity Type:Organization
Organization Name:DELTA COMMUNITY SUPPORTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT COST ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH-CLEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-654-1000
Mailing Address - Street 1:1777 SENTRY PKWY W # VEVA14
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2207
Mailing Address - Country:US
Mailing Address - Phone:215-654-1000
Mailing Address - Fax:215-641-0393
Practice Address - Street 1:26 N LADOW AVE APT 15B
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-1431
Practice Address - Country:US
Practice Address - Phone:856-293-1622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0486612OtherDDD