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Provider Demographic Information - EASTWICK FAMILY SERVICES

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	EASTWICK FAMILY SERVICES
Address:	2501 S CARROLL ST PHILADELPHIA, PA 19142-2112
Phone:	(267) 634-6410
Fax:	(267) 645-6439
E-mail:	DSumo@Eastwickfamily.com
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header


Type:	Corporate Office
Name:	Eastwick Family Services LLC
Address:	2638 S LLOYD ST PHILADELPHIA, PA 19153-2419
Phone:	(267) 709-5589

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Berks
\|Service Name / Level	\|Rate

Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day

County : Bucks
\|Service Name / Level	\|Rate

In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Respite-Lic-Day-1 person-NG 3	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 4	$931.37 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency	$931.37 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$474.70 / 1 Day
Respite-Lic-Day-2 person-NG 2	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 3	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 4	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG1	$474.70 / 1 Day
Respite-Lic-Day-3 person-NG 1	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 2	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 3	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 4	$538.34 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$538.34 / 1 Day
Respite-Lic-Day-4 person-NG 1	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 2	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 3	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 4	$422.61 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$422.61 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.26 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) Out-of-Home	$2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$20.13 / 15 min.
Respite-Unlic-15min(Lvl 4,2:1) Out of Home	$15.77 / 15 min.
Respite-Unlic-Day (Basic 1:4) Out-of-Home	$90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$630.98 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$805.07 / 1 Day
Supported Employment-Career Assessment	$19.34 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$19.34 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.

County : Chester
\|Service Name / Level	\|Rate

Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Respite-Lic-Day-1 person-NG 3	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 4	$931.37 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency	$931.37 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$474.70 / 1 Day
Respite-Lic-Day-2 person-NG 2	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 3	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 4	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG1	$474.70 / 1 Day
Respite-Lic-Day-3 person-NG 1	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 2	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 3	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 4	$538.34 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$538.34 / 1 Day
Respite-Lic-Day-4 person-NG 1	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 2	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 3	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 4	$422.61 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$422.61 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.26 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) Out-of-Home	$2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$20.13 / 15 min.
Respite-Unlic-15min(Lvl 4,2:1) Out of Home	$15.77 / 15 min.
Respite-Unlic-Day (Basic 1:4) Out-of-Home	$90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$630.98 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$805.07 / 1 Day
Supported Employment-Career Assessment	$19.34 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$19.34 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.

County : Delaware
\|Service Name / Level	\|Rate

Companion Services (Level 2)	$8.33 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-1 Person-Inelig	$105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Respite-Lic-Day-1 person-NG 3	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 4	$931.37 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency	$931.37 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$474.70 / 1 Day
Respite-Lic-Day-2 person-NG 2	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 3	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 4	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG1	$474.70 / 1 Day
Respite-Lic-Day-3 person-NG 1	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 2	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 3	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 4	$538.34 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$538.34 / 1 Day
Respite-Lic-Day-4 person-NG 1	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 2	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 3	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 4	$422.61 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$422.61 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.26 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) Out-of-Home	$2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$20.13 / 15 min.
Respite-Unlic-15min(Lvl 4,2:1) Out of Home	$15.77 / 15 min.
Respite-Unlic-Day (Basic 1:4) Out-of-Home	$90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$630.98 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$805.07 / 1 Day
Supported Employment-Career Assessment	$19.34 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$19.34 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.

County : Lancaster
\|Service Name / Level	\|Rate

Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day

County : Montgomery
\|Service Name / Level	\|Rate

In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Respite-Lic-Day-1 person-NG 3	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 4	$931.37 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency	$931.37 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$474.70 / 1 Day
Respite-Lic-Day-2 person-NG 2	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 3	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 4	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG1	$474.70 / 1 Day
Respite-Lic-Day-3 person-NG 1	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 2	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 3	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 4	$538.34 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$538.34 / 1 Day
Respite-Lic-Day-4 person-NG 1	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 2	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 3	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 4	$422.61 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$422.61 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.26 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) Out-of-Home	$2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$20.13 / 15 min.
Respite-Unlic-15min(Lvl 4,2:1) Out of Home	$15.77 / 15 min.
Respite-Unlic-Day (Basic 1:4) Out-of-Home	$90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$630.98 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$805.07 / 1 Day
Supported Employment-Career Assessment	$19.34 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$19.34 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.

County : Philadelphia
\|Service Name / Level	\|Rate

Companion Services (Level 2)	$8.33 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-1 Person-Inelig	$105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Respite-Lic-Day-1 person-NG 3	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 4	$931.37 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency	$931.37 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$474.70 / 1 Day
Respite-Lic-Day-2 person-NG 2	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 3	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 4	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG1	$474.70 / 1 Day
Respite-Lic-Day-3 person-NG 1	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 2	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 3	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 4	$538.34 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$538.34 / 1 Day
Respite-Lic-Day-4 person-NG 1	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 2	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 3	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 4	$422.61 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$422.61 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.26 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) Out-of-Home	$2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$20.13 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$20.13 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-15min(Lvl 4,2:1) Out of Home	$15.77 / 15 min.
Respite-Unlic-Day (Basic 1:4) Out-of-Home	$90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$630.98 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$805.07 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$805.07 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supported Employment-Career Assessment	$19.34 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$19.34 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.

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