Provider Demographics
NPI:1700239407
Name:MBS CONNECTION
Entity Type:Organization
Organization Name:MBS CONNECTION
Other - Org Name:HOMECARE ASSISTANCE DELAWARE VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DANGELO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:856-287-1319
Mailing Address - Street 1:904 ROUTE 73 N
Mailing Address - Street 2:
Mailing Address - City:EVESHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1230
Mailing Address - Country:US
Mailing Address - Phone:856-596-8276
Mailing Address - Fax:856-596-8248
Practice Address - Street 1:904 ROUTE 73 N
Practice Address - Street 2:
Practice Address - City:EVESHAM
Practice Address - State:NJ
Practice Address - Zip Code:08053-1230
Practice Address - Country:US
Practice Address - Phone:856-596-8276
Practice Address - Fax:856-596-8348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0212500251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health