Provider Demographics
NPI:1700143740
Name:DELAWARE VALLEY RESIDENTIAL CARE LLC
Entity type:Organization
Organization Name:DELAWARE VALLEY RESIDENTIAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-681-4697
Mailing Address - Street 1:1430 DEKALB ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3406
Mailing Address - Country:US
Mailing Address - Phone:484-681-4697
Mailing Address - Fax:484-674-7039
Practice Address - Street 1:280 JACKSONVILLE RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-4425
Practice Address - Country:US
Practice Address - Phone:484-681-4697
Practice Address - Fax:484-674-7039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness