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General NPI Number Information
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NPI Number | 1114141769
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Entity Type | Organization
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Legal Business Name | OVERBROOK FRIEDLANDER PROGRAMS
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 1900 WYNNEWOOD RD
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City | PHILADELPHIA
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State | PA
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Zip | 19151-2535
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Country | US
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Telephone | 215-877-0017
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Fax | 215-877-5039
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Provider Business Mailing Address
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Address Line | 1900 WYNNEWOOD RD
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City | PHILADELPHIA
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State | PA
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Zip | 19151-2535
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Country | US
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Telephone | 215-877-0017
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Fax | 215-877-5039
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Authorized Official
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Title or Position | PROGRAM ADMINISTRATOR
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Name | MS. MICHELE C RHODES
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Credential |
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Telephone | 215-877-0017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 515160
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License Number State | PA
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