1669993366 NPI number — KITHS INTEGRATED AND TARGETED HUMAN SERVICES

Table of content: (NPI 1669993366)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669993366 NPI number — KITHS INTEGRATED AND TARGETED HUMAN SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KITHS INTEGRATED AND TARGETED HUMAN SERVICES
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:
KITHS, INC
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:
1669993366
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5812 NEWTOWN 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:
19120-1129
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-278-6222
Provider Business Mailing Address Fax Number:
215-914-6961

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4911 OLD YORK RD FL 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19141-2704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-278-6222
Provider Business Practice Location Address Fax Number:
215-914-6961
Provider Enumeration Date:
07/03/2017

Additional Information

Authorized Official

Authorized Official Last Name:
KITH
Authorized Official First Name:
NARY
Authorized Official Middle Name:
P
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
215-278-6222

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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