Provider Demographics
NPI:1073811162
Name:PROJECT 4EVER STRIVING INC.
Entity Type:Organization
Organization Name:PROJECT 4EVER STRIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE
Authorized Official - Prefix:MISS
Authorized Official - First Name:LETITIA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-968-0607
Mailing Address - Street 1:2418 W YORK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-4233
Mailing Address - Country:US
Mailing Address - Phone:267-968-0607
Mailing Address - Fax:
Practice Address - Street 1:2418 W YORK ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-4233
Practice Address - Country:US
Practice Address - Phone:267-968-0607
Practice Address - Fax:215-225-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health