Provider Demographics
NPI:1093859878
Name:ALDIE FOUNDATION
Entity Type:Organization
Organization Name:ALDIE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRKELBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MRP
Authorized Official - Phone:215-345-8530
Mailing Address - Street 1:11 WELDEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901
Mailing Address - Country:US
Mailing Address - Phone:215-345-8530
Mailing Address - Fax:215-345-5423
Practice Address - Street 1:11 WELDEN DRIVE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:215-345-8530
Practice Address - Fax:215-345-5423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA092344251S00000X
PAFACILITYNUMBER092344251S00000X, 261Q00000X, 261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0545233Medicaid
PA0545233Medicaid