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Organization

NORTHERN HOME CHILDREN AND FAMILY SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RENATA COBBS-FLETCHER M.S. (PRESIDENT AND CEO)
(215) 482-1423
Entity
Organization

Contact information

Practice address
5301 RIDGE AVE, PHILADELPHIA, PA 19128-3757
(215) 482-1423
(215) 483-7855
Mailing address
5301 RIDGE AVE, PHILADELPHIA, PA 19128-3757
(215) 482-1423
(215) 483-7855

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007782000001
PA
05
1007782000003
PA
05
1007782000004
PA
05
1007782000009
PA
05
1007782000010
PA
05
1007782000011
PA
05
1007782000100
PA
05
1007782000101
PA
05
1007782000102
PA
05
1007782001009
PA
Enumeration date
04/25/2007
Last updated
03/24/2016
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