Provider Demographics
NPI:1912983974
Name:TOWER HEALTH AT HOME - POTTSTOWN
Entity Type:Organization
Organization Name:TOWER HEALTH AT HOME - POTTSTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNANN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:DECUSATIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:610-378-0481
Mailing Address - Street 1:1170 BERKSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1215
Mailing Address - Country:US
Mailing Address - Phone:610-378-0481
Mailing Address - Fax:610-378-9762
Practice Address - Street 1:1963 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3209
Practice Address - Country:US
Practice Address - Phone:610-327-5700
Practice Address - Fax:610-327-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA700805251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
20007969OtherAMERIHEALTH MERCY
0000828000OtherIBC BABY BLUE PRINT
00709363-01OtherAMERCHOICE
144363OtherMEDPLUS
31756OtherAETNA
1141OtherGENTIVA CARE CENTRIX
1683OtherHIGHMARK
21740OtherSENIOR PARTNERS
21740OtherHEALTH PARTNERS
PA1007496750003Medicaid
0002893000OtherIBC MOTHER OPTIONS
0007568000OtherIBC
1022268OtherKEYSTONE MERCY
231232574OtherBLACK LUNG
PA1007496750003Medicaid