Healthcare Provider Details

I. General information

NPI: 1033418934
Provider Name (Legal Business Name): AMUDIPES RESIDENTIAL AND DAY TREATMENT FACILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 07/21/2022
Certification Date:
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: 215-888-5667
  • Fax: 267-295-2644
Mailing address:
  • Phone: 215-888-5667
  • Fax: 267-295-2644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT010345L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License NumberSL006108L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StatePA

VIII. Authorized Official

Name: MRS. ELLEN AMUDIPE
Title or Position: PRESIDENT
Credential:
Phone: 215-888-5667