=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831314467
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMUNITY WRAPAROUND
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 931 CLINTON STREET SUITE 104
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-931-0371
-----------------------------------------------------
Fax | 215-931-0371
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 108 1/2 GLEN VALLEY ROAD
-----------------------------------------------------
City | YARDLEY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-931-0371
-----------------------------------------------------
Fax | 215-931-0371
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | DR. ROBERT HANDFINGER
-----------------------------------------------------
Credential | EDD
-----------------------------------------------------
Telephone | 215-931-0371
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 0103233
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------