Healthcare Provider Details

I. General information

NPI: 1093469694
Provider Name (Legal Business Name): A BETTER YOU A BETTER ME EARLY INTERVENTION AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4057 BALWYNNE PARK RD
PHILA PA
19131-1601
US

IV. Provider business mailing address

45 E CITY AVE # 2712
BALA CYNWYD PA
19004-2421
US

V. Phone/Fax

Practice location:
  • Phone: 215-380-5354
  • Fax:
Mailing address:
  • Phone: 215-380-5354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LATOYA MONTGOMERY
Title or Position: OWNER/DIRECTOR
Credential: MD
Phone: 215-380-5354