# FORGET ME KNOT YOUTH SERVICES

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

## Provider details

- **NPI number:** 1518407519
- **Authorized official:** QUINZELLE BETHEA (DIRECTOR)
- **Authorized official phone:** (215) 758-1153

## Contact information

- **Practice address:** 2321 N BROAD STREET, PHILADELPHIA, PA 19132
- **Practice address phone:** (215) 758-1153
- **Mailing address:** 2321 N BROAD STREET, PHILADELPHIA, PA 19132
- **Mailing address phone:** (215) 758-1153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 02/24/2017
- **Last updated:** 02/24/2017