Provider Demographics
NPI:1720831803
Name:BLACK GIRL HEALTH FOUNDATION INC
Entity Type:Organization
Organization Name:BLACK GIRL HEALTH FOUNDATION INC
Other - Org Name:THE BGH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAPORCHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-299-6285
Mailing Address - Street 1:911 GIBSON BLVD
Mailing Address - Street 2:
Mailing Address - City:STEELTON
Mailing Address - State:PA
Mailing Address - Zip Code:17113-1860
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:911 GIBSON BLVD
Practice Address - Street 2:
Practice Address - City:STEELTON
Practice Address - State:PA
Practice Address - Zip Code:17113-1860
Practice Address - Country:US
Practice Address - Phone:240-299-6285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)