Organization
ELWYN OF PENNSYLVANIA AND DELAWARE
Active
Other names
ICF MR ADULT MAIN CAMPUS
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA K BUSCH (DIR CONTRACTING AND CREDENTIALING)
(452) 063-0284
Entity
Organization
Contact information
Practice address
111 ELWYN RD, ICF MR ADULT RESIDENTIAL, ELWYN, PA 19063-4622
(610) 891-7692
Mailing address
111 ELWYN RD, ICF MR ADULT RESIDENTIAL, ELWYN, PA 19063-4622
(610) 891-7692
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000021240254
—
PA
Enumeration date
02/07/2007
Last updated
05/06/2024
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