Healthcare Provider Details

I. General information

NPI: 1942078852
Provider Name (Legal Business Name): SPECIAL PEOPLE IN NORTHEAST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10501 DRUMMOND RD
PHILADELPHIA PA
19154-3807
US

IV. Provider business mailing address

10501 DRUMMOND RD
PHILADELPHIA PA
19154-3807
US

V. Phone/Fax

Practice location:
  • Phone: 215-612-7625
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KATE CITRO
Title or Position: DIVISION DIRECTOR, OPERATIONS
Credential:
Phone: 267-439-1296