MEDICARE: RESOURCES FOR HUMAN DEVELOPMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1124787304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESOURCES FOR HUMAN DEVELOPMENT, INC.

Provider Business Mailing Address
First Line	:	4700 WISSAHICKON AVE STE 118
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-4248
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 W MASTER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-4996
Country	:	US
Telephone Number	:	267-687-1172
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	EMILY NICHOLS
Credential	:
Telephone Number	:	267-597-3604

Provider Enumeration Date	:	12/15/2021
Last Update Date	:	10/03/2024

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