Basic Information
| Provider Information | |||||||||
| NPI: | 1780715789 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RESOURCES FOR HUMAN DEVELOPMENT, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RHD | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 WISSAHICKON AVE | ||||||||
| Address2: | SUITE 126 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191444248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159510300 | ||||||||
| FaxNumber: | 2159510312 | ||||||||
| Practice Location | |||||||||
| Address1: | 14701 AVERY RD | ||||||||
| Address2: | |||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208533605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012798828 | ||||||||
| FaxNumber: | 3102798910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 04/26/2010 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 06/03/2008 | ||||||||
| NPIReactivationDate: | 04/19/2010 | ||||||||
| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | FISHMAN | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2159510300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 323P00000X | 903103 | MD | N | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | 324500000X | 903103 | MD | N | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | 323P00000X | MD | Y | Residential Treatment Facilities | Psychiatric Residential Treatment Facility |
ID Information
| ID | Type | State | Issuer | Description | 413790600 | 05 | MD | MEDICAID |