Healthcare Provider Details

I. General information

NPI: 1225207491
Provider Name (Legal Business Name): RESOURCES FOR HUMAN DEVELOPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

947 CLARION DR
DURHAM NC
27705-1730
US

IV. Provider business mailing address

811 UNDERWOOD AVE APT. C-9
DURHAM NC
27701-2988
US

V. Phone/Fax

Practice location:
  • Phone: 919-489-8717
  • Fax: 919-489-8904
Mailing address:
  • Phone: 919-489-8717
  • Fax: 919-489-8904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberMHL 032413
License Number StateNC

VIII. Authorized Official

Name: MR. ROBERT FISHMAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 800-894-9925