Provider Demographics
NPI:1295485696
Name:CHESTER COUNTY RESPITE NETWORK, LLC
Entity type:Organization
Organization Name:CHESTER COUNTY RESPITE NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF OPERATIONS AND CLINICAL
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LBS LCDP LMSW
Authorized Official - Phone:484-879-2222
Mailing Address - Street 1:495 HIGHLAND BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-5822
Mailing Address - Country:US
Mailing Address - Phone:484-979-2222
Mailing Address - Fax:484-879-2223
Practice Address - Street 1:495 HIGHLAND BLVD STE 104
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-5822
Practice Address - Country:US
Practice Address - Phone:484-979-2222
Practice Address - Fax:484-879-2223
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ROCK CREEK FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health