MEDICARE: MAKE IT HAPPEN PHILY 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	347C00000X	Private Vehicle

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700595808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAKE IT HAPPEN PHILY INC

Provider Business Mailing Address
First Line	:	1217 HERBERT ST
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19124-2934
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8707 W CHESTER PIKE
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-1115
Country	:	US
Telephone Number	:	215-917-7647
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CHERYL HARRIS
Credential	:
Telephone Number	:	215-917-7647

Provider Enumeration Date	:	11/16/2022
Last Update Date	:	11/16/2022

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Directions to “MAKE IT HAPPEN PHILY INC ” Practice Location

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