Provider Demographics
NPI:1932582293
Name:FIRELY HOME FOR KIDS
Entity Type:Organization
Organization Name:FIRELY HOME FOR KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:OLEKSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-513-7455
Mailing Address - Street 1:3082 PRUSS HILL RD
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-2217
Mailing Address - Country:US
Mailing Address - Phone:215-513-7455
Mailing Address - Fax:215-513-3031
Practice Address - Street 1:3082 PRUSS HILL RD
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-2217
Practice Address - Country:US
Practice Address - Phone:215-513-7455
Practice Address - Fax:215-513-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X, 322D00000X
PA1411903140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No251K00000XAgenciesPublic Health or Welfare
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children