Provider Demographics
NPI:1689357782
Name:RESOURCES FOR HUMAN DEVELOPMENT, INC.
Entity Type:Organization
Organization Name:RESOURCES FOR HUMAN DEVELOPMENT, INC.
Other - Org Name:FPCN AT BARTRAM HIGH SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-597-3604
Mailing Address - Street 1:4700 WISSAHICKON AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4248
Mailing Address - Country:US
Mailing Address - Phone:267-597-3604
Mailing Address - Fax:
Practice Address - Street 1:2401 S 67TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-2229
Practice Address - Country:US
Practice Address - Phone:215-400-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESOURCES FOR HUMAN DEVELOPMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-08
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)