NPIMap

Organization Active NPI

Carelink Community Support Services of Pennsylvania Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Wallingford, PA
National Provider Identifier
1457974313
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
CARELINK COMMUNITY SUPPORT SERVICES OF PENNSYLVANIA INC
Practice address
614 W Brookhaven Rd
Wallingford, PA 19086-6812
Phone
(610) 874-1119
Fax
(610) 565-3801
NPI assigned
May 26, 2020
Last updated
Nov 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gary Woomer
Title
Ceo
Phone
(610) 874-1119

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

614 W Brookhaven Rd
Wallingford, PA 19086-6812

Mailing address

106 Chesley Dr
Media, PA 19063-1759
Phone (610) 874-1119

National Provider Directory

National Provider Directory
Tax ID family
Carelink Community Support Services of Pennsylvania Inc39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1457974313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CHESLEY DR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631759",
            "telephone_number": "610-874-1119",
            "fax_number": "610-565-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 W BROOKHAVEN RD",
            "city": "WALLINGFORD",
            "state": "PA",
            "postal_code": "190866812",
            "telephone_number": "610-874-1119",
            "fax_number": "610-565-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARELINK COMMUNITY SUPPORT SERVICES OF PENNSYLVANIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "WOOMER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "610-874-1119"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.