Organization
WORDSWORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA LACKS (CEO)
(215) 643-5400
Entity
Organization
Contact information
Practice address
2101 PENNSYLVANIA AVE, FORT WASHINGTON, PA 19034-2912
(800) 769-0088
Mailing address
3905 FORD RD, PHILADELPHIA, PA 19131-2824
(215) 643-5400
(215) 871-3412
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407806433
—
PA
Enumeration date
04/19/2013
Last updated
04/19/2013
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