Provider Demographics
NPI:1467505065
Name:INTERCULTURAL FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:INTERCULTURAL FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHA-HIDALGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-386-1298
Mailing Address - Street 1:4225 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3014
Mailing Address - Country:US
Mailing Address - Phone:215-386-1298
Mailing Address - Fax:215-386-9348
Practice Address - Street 1:4254-56 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-386-8490
Practice Address - Fax:215-386-8494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA105010103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA016434P8GMedicaid
PA1007824340001Medicare ID - Type Unspecified