Provider Demographics
NPI:1477910800
Name:UN PASO ADELANTE, LLC
Entity Type:Organization
Organization Name:UN PASO ADELANTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-306-8981
Mailing Address - Street 1:108 RIVERBIRCH CIR
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQ
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1678
Mailing Address - Country:US
Mailing Address - Phone:610-306-8981
Mailing Address - Fax:
Practice Address - Street 1:3314 OLD CAPITOL TRL OFC 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-6276
Practice Address - Country:US
Practice Address - Phone:610-306-8981
Practice Address - Fax:302-516-7672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00012031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1083804Medicaid