Provider Demographics
NPI:1780715789
Name:RESOURCES FOR HUMAN DEVELOPMENT, INC.
Entity type:Organization
Organization Name:RESOURCES FOR HUMAN DEVELOPMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-951-0300
Mailing Address - Street 1:4700 WISSAHICKON AVE
Mailing Address - Street 2:SUITE 126
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4248
Mailing Address - Country:US
Mailing Address - Phone:215-951-0300
Mailing Address - Fax:215-951-0312
Practice Address - Street 1:14701 AVERY RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-3605
Practice Address - Country:US
Practice Address - Phone:301-279-8828
Practice Address - Fax:310-279-8910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2010-04-26
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2010-04-19
Provider Licenses
StateLicense IDTaxonomies
MD903103323P00000X, 324500000X
MD323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD413790600Medicaid