Organization
PROVIDER OF CO-OP SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHRYN LAURIE STEIN (OWNER)
(610) 453-5005
Entity
Organization
Contact information
Practice address
1467 HARK A WAY RD, CHESTER SPRINGS, PA 19425-2302
(610) 453-5005
Mailing address
1467 HARK A WAY RD, CHESTER SPRINGS, PA 19425-2302
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN517919L
PA
251C00000X
Developmentally Disabled Services Day Training Agency
102276610
PA
251K00000X
Public Health or Welfare Agency
102276610
PA
251S00000X
Community/Behavioral Health Agency
102276610
PA
302F00000X
Exclusive Provider Organization
Primary
102276610
PA
385H00000X
Respite Care
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102276610
CONSOLIDATED, BASE AND PERSON/FAMILY WAIVER
PA
01
—
102276610
OBRA, COMMCARE AND INDEPENDANCE WAIVER
—
05
—
102276610
—
PA
Enumeration date
06/29/2009
Last updated
02/29/2016
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