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Organization
FATHERSHIP FOUNDATION
Active
Organization
FATHERSHIP FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN WILSON JR. DR. (EXECUTIVE DIRECTOR)
(267) 232-8383
Entity
Organization
Contact information
Practice address
6504 ELMWOOD AVE, PHILADELPHIA, PA 19142-2817
(267) 232-8383
Mailing address
6504 ELMWOOD AVE, PHILADELPHIA, PA 19142-2817
(267) 232-8383
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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