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General NPI Number Information
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NPI Number | 1639203904
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Entity Type | Organization
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Legal Business Name | CENTER FOR FAMILY DEVELOPMENT,LLC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1120 EASTON ROAD SUITE ONE
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City | WILLOW GROVE
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State | PA
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Zip | 19090
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Country | US
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Telephone | 215-830-8430
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Fax | 215-830-8432
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Provider Business Mailing Address
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Address Line | 1224 DUNCAN DRIVE
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City | DRESHER
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State | PA
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Zip | 19025
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Country | US
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Telephone | 215-659-9199
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Fax | 215-830-8432
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ERNEST GLAZER
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Credential | LCSW
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Telephone | 215-659-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW014059
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License Number State | PA
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