1699986844 NPI number — THE CENTER FOR GROWTH

Table of content: (NPI 1699986844)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699986844 NPI number — THE CENTER FOR GROWTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CENTER FOR GROWTH
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:
Provider Other Organization Name Type Code:
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:
1699986844
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
233 S 6TH ST
Provider Second Line Business Mailing Address:
SUITE C-33
Provider Business Mailing Address City Name:
PHILA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19106-3749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-570-8614
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
233 S 6TH ST
Provider Second Line Business Practice Location Address:
SUITE C-33
Provider Business Practice Location Address City Name:
PHILA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19106-3749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-570-8614
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROBBOY
Authorized Official First Name:
CAROLINE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
FOUNDER
Authorized Official Telephone Number:
267-324-9564

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  PC003777 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: SW011892L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CW013529 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: MF000482 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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