# MELMARK, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861568107
- **Authorized official:** MR. THOMAS J CROFCHECK CPA (VICE PRESIDENT & CFO)
- **Authorized official phone:** (610) 325-4935

## Contact information

- **Practice address:** 2600 WAYLAND RD, BERWYN, PA 19312-2307
- **Practice address phone:** (610) 353-1726
- **Practice address fax:** (610) 353-4956
- **Mailing address:** 2600 WAYLAND RD, BERWYN, PA 19312-2307
- **Mailing address phone:** (610) 353-1726
- **Mailing address fax:** (610) 353-4956

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 164W00000X | Licensed Practical Nurse | — | NULL | — |
| 164W00000X | Licensed Practical Nurse | — | — | — |
| 207Q00000X | Family Medicine Physician | — | PA | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | PA | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | PA | — |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | — |
| 315P00000X | Intellectual Disabilities Intermediate Care Facility | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 123940 | PA | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 323P00000X | Psychiatric Residential Treatment Facility | 123940 | PA | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | PA | — |

## Other

- **Enumeration date:** 11/28/2006
- **Last updated:** 12/09/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100002358 | — | PA |