1265682389 NPI number — RESOURCES FOR HUMAN DEVELOPMENT

Table of content: (NPI 1265682389)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265682389 NPI number — RESOURCES FOR HUMAN DEVELOPMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESOURCES FOR HUMAN DEVELOPMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RHD MONTROSE DRIVE GROUP HOME
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265682389
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4700 WISSAHICKON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19144-4248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-351-0300
Provider Business Mailing Address Fax Number:
215-951-0312

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 MONTROSE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19713-2757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-731-5283
Provider Business Practice Location Address Fax Number:
302-731-5409
Provider Enumeration Date:
09/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GIORDANO
Authorized Official First Name:
MARCO
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
215-951-0300

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 311ZA0620X , with the licence number: 2171 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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