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Organization

A HOME FOR RENEWAL INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANYIKIA S. ALSTON LBS (CEO)
(215) 520-5868
Entity
Organization

Contact information

Practice address
118 MONTGOMERY AVE APT C1-2, BALA CYNWYD, PA 19004-2962
(215) 520-5868
Mailing address
118 MONTGOMERY AVE APT C1-2, BALA CYNWYD, PA 19004-2962
(215) 520-5868

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
10/29/2024
Last updated
10/29/2024
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