# EMBOLDEN COMMUNITY ALLIES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104463736
- **Authorized official:** CINDI MUCHOKI (CEO)
- **Authorized official phone:** (267) 810-4866

## Contact information

- **Practice address:** 4000 GYPSY LN UNIT 204, PHILADELPHIA, PA 19129-5405
- **Practice address phone:** (267) 810-4866
- **Mailing address:** 4000 GYPSY LN UNIT 204, PHILADELPHIA, PA 19129-5405
- **Mailing address phone:** (267) 810-4866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 12/02/2019
- **Last updated:** 12/02/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 103643212 | — | PA |