Organization
ELWYN OF PENNSYLVANIA AND DELAWARE
Active
Other names
Evergreen 2
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA K BUSCH (PAYER CONTRACT SPECIALIST)
(445) 206-3028
Entity
Organization
Contact information
Practice address
111 ELWYN RD, MEDIA, PA 19063-4622
(610) 891-7007
(610) 891-2666
Mailing address
111 ELWYN RD, MEDIA, PA 19063-4622
(610) 891-7007
(610) 891-2666
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000021240700
—
PA
Enumeration date
08/11/2020
Last updated
09/17/2025
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