Basic Information
| Provider Information | |||||||||
| NPI: | 1205324720 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RESOURES FOR HUMAN DEVELOPMENT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 WISSAHICKON AVE STE 126 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191444248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159510300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 810 MONONGAHELA AVE | ||||||||
| Address2: | |||||||||
| City: | GLASSPORT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150451627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127383751 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2018 | ||||||||
| LastUpdateDate: | 04/30/2018 | ||||||||
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| AuthorizedOfficialLastName: | ADER | ||||||||
| AuthorizedOfficialFirstName: | KENNETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRES REVENUE CYCLE MGMT | ||||||||
| AuthorizedOfficialTelephone: | 2159510300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.