Healthcare Provider Details

I. General information

NPI: 1730005265
Provider Name (Legal Business Name): RADIANT SPRINGS SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 OXFORD CIR
LANSDALE PA
19446-6635
US

IV. Provider business mailing address

1204 OXFORD CIR
LANSDALE PA
19446-6635
US

V. Phone/Fax

Practice location:
  • Phone: 484-951-8916
  • Fax:
Mailing address:
  • Phone: 484-951-8916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ERIKA ALLEN
Title or Position: OWNER
Credential:
Phone: 484-951-8916