Healthcare Provider Details

I. General information

NPI: 1750105714
Provider Name (Legal Business Name): MY CHILD MY FRIEND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 NORRISTOWN RD
BLUE BELL PA
19422-2802
US

IV. Provider business mailing address

90 NORRISTOWN RD
BLUE BELL PA
19422-2802
US

V. Phone/Fax

Practice location:
  • Phone: 215-858-7685
  • Fax:
Mailing address:
  • Phone: 215-858-7685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ELLEN AMUDIPE
Title or Position: PRESIDENT
Credential:
Phone: 215-858-7685