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General NPI Number Information
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NPI Number | 1144360660
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Entity Type | Organization
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Legal Business Name | YOUTH BUILD PHILA CHARTER SCHOOL
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1231 N BROAD ST 3RD FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19122-4021
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Country | US
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Telephone | 215-627-8671
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Fax | 215-763-5774
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Provider Business Mailing Address
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Address Line | 1231 N BROAD ST 3RD FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19122-4021
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Country | US
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Telephone | 215-627-8671
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Fax | 215-763-5774
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SIMRAN SIDHU
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Credential |
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Telephone | 215-627-8671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | PA
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