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General NPI Number Information
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NPI Number | 1629749791
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Entity Type | Organization
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Legal Business Name | 412 FOSTER PROJECT
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 561 LINCOLN AVE
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City | BELLEVUE
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State | PA
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Zip | 15202-3531
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Country | US
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Telephone | 412-874-6015
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Fax |
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Provider Business Mailing Address
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Address Line | 924 LIMESTONE DR
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City | ALLISON PARK
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State | PA
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Zip | 15101-4228
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Country | US
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Telephone | 412-874-6015
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Fax |
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | JENNA BOSI
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Credential |
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Telephone | 412-874-6015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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