Provider Demographics
NPI:1578210712
Name:ELLE & ME DEVELOPMENTAL AND BEHVAVIORAL SERIVES
Entity Type:Organization
Organization Name:ELLE & ME DEVELOPMENTAL AND BEHVAVIORAL SERIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NAESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-620-3563
Mailing Address - Street 1:1620 FARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2714
Mailing Address - Country:US
Mailing Address - Phone:484-620-3563
Mailing Address - Fax:
Practice Address - Street 1:1620 FARRINGTON RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2714
Practice Address - Country:US
Practice Address - Phone:484-620-3563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty