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General NPI Number Information
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NPI Number | 1063641330
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Entity Type | Organization
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Legal Business Name | CENTER FOR FAMILY DEVELOPMENT SERVICES LLC
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 07/08/2009
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Provider Practice Location Address
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Address Line | 1015 WAGNER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19141-2927
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Country | US
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Telephone | 267-304-0981
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Fax | 302-832-6830
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Provider Business Mailing Address
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Address Line | 1015 WAGNER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19141-2927
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Country | US
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Telephone | 267-304-0981
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Fax | 302-832-6830
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MOSES EMMANUEL ANYAEGBU
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Credential | MSW
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Telephone | 267-304-0981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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