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General NPI Number Information
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NPI Number | 1972355253
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Entity Type | Organization
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Legal Business Name | PATELZ
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Dates
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Enumeration Date | 04/02/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 923 RUE MADORA
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City | BEAR
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State | DE
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Zip | 19701-2545
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Country | US
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Telephone | 610-506-0915
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Fax |
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Provider Business Mailing Address
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Address Line | 2007 KATER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1312
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Country | US
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Telephone | 610-506-0915
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEBBEH MOLUWOI
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Credential | BS, BSN,RN
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Telephone | 610-506-0915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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