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General NPI Number Information
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NPI Number | 1811255888
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Entity Type | Organization
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Legal Business Name | PEOPLE R US COMMUNITY RESDENTIAL SERVICES
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 2101 W TIOGA ST 2103 WEST TIOGA STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19140-3922
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Country | US
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Telephone | 267-639-3135
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Fax | 267-909-8663
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Provider Business Mailing Address
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Address Line | 2101-03 WEST TIOGA STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19140-3922
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Country | US
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Telephone | 267-639-3135
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Fax | 267-909-8663
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DARRIN MOLLETTA
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Credential |
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Telephone | 267-639-3135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number | 807417
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number | 137880
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License Number State | PA
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