Healthcare Provider Details

I. General information

NPI: 1265872774
Provider Name (Legal Business Name): RESOURCES FOR HUMAN DEVELOPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 FOX ST
PHILADELPHIA PA
19129-1838
US

IV. Provider business mailing address

4700 WISSAHICKON AVE STE 118
PHILADELPHIA PA
19144-4248
US

V. Phone/Fax

Practice location:
  • Phone: 267-597-3605
  • Fax:
Mailing address:
  • Phone: 267-597-3605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARCO GIORDANO
Title or Position: CEO
Credential:
Phone: 267-597-3605