Provider Demographics
NPI:1356023899
Name:CARELINK COMMUNITY SUPPORT SERVICES OF PENNSYLVANIA INC
Entity type:Organization
Organization Name:CARELINK COMMUNITY SUPPORT SERVICES OF PENNSYLVANIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-874-1119
Mailing Address - Street 1:106 CHESLEY DR
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1759
Mailing Address - Country:US
Mailing Address - Phone:610-874-1119
Mailing Address - Fax:610-565-3801
Practice Address - Street 1:2691 MANOR RD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1257
Practice Address - Country:US
Practice Address - Phone:484-441-3555
Practice Address - Fax:610-679-5790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health