Basic Information
Provider Information
NPI: 1043689938
EntityType: 2
ReplacementNPI:  
OrganizationName: RESOURCES FOR HUMAN DEVELOPMENT, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: RHD POSITIVE RESOLUTIONS STE 3
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4700 WISSAHICKON AVE
Address2: SUITE 126
City: PHILADELPHIA
State: PA
PostalCode: 191444248
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 718 SWEDE ST
Address2: SUITE 3
City: NORRISTOWN
State: PA
PostalCode: 194013938
CountryCode: US
TelephoneNumber: 6102398500
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/21/2015
LastUpdateDate: 09/21/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ROTH
AuthorizedOfficialFirstName: DYANN
AuthorizedOfficialMiddleName: M
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 2159510300
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

ID Information
IDTypeStateIssuerDescription
100001708-059905PA MEDICAID


Home