Basic Information
| Provider Information | |||||||||
| NPI: | 1922367986 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RESOURCES FOR HUMAN DEVELPMENT, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 WISSAHICKON AVENUE | ||||||||
| Address2: | SUITE 126 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191444248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159510300 | ||||||||
| FaxNumber: | 8773863756 | ||||||||
| Practice Location | |||||||||
| Address1: | 5201 OLD YORK ROAD | ||||||||
| Address2: | SUITE 109 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191412985 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143247386 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2012 | ||||||||
| LastUpdateDate: | 11/12/2014 | ||||||||
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| AuthorizedOfficialLastName: | ROTH | ||||||||
| AuthorizedOfficialFirstName: | DYANN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2159510300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | RESOURCES FOR HUMAN DEVELOPMENT, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 138730 | PA | N | Agencies | Community/Behavioral Health | 251S00000X | 138340 | N | Agencies | Community/Behavioral Health | 261Q00000X | 138730 | PA | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.