Provider Demographics
NPI:1033418934
Name:AMUDIPES RESIDENTIAL AND DAY TREATMENT FACILITIES
Entity Type:Organization
Organization Name:AMUDIPES RESIDENTIAL AND DAY TREATMENT FACILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMUDIPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-888-5667
Mailing Address - Street 1:90 NORRISTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2802
Mailing Address - Country:US
Mailing Address - Phone:215-888-5667
Mailing Address - Fax:267-295-2644
Practice Address - Street 1:90 NORRISTOWN RD
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2802
Practice Address - Country:US
Practice Address - Phone:215-888-5667
Practice Address - Fax:267-295-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010345L225100000X
PASL006108L235500000X
251C00000X, 320600000X, 320900000X
PA385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite Care
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty