Embolden Community Allies
Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Address: 4000 Gypsy Ln Unit 204, Philadelphia, PA 19129-5405
Phone: 2678104866

Embolden Community Allies (NPI# 1104463736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1104463736
Entity Type Organization
Organization Name EMBOLDEN COMMUNITY ALLIES
Practice Address 4000 Gypsy Ln Unit 204
Philadelphia
PA 19129-5405
Practice Telephone 2678104866
Mailing Address 4000 Gypsy Ln Unit 204
Philadelphia
PA 19129-5405
Mailing Telephone 2678104866
Authorized Official Name Cindi Muchoki (CEO)
Authorized Official Telephone 2678104866
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2019-12-02
Last Update Date 2019-12-02

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities

Other Provider Identifier

State Identifier Issuer Type Code
PA 103643212 MEDICAID

Taxonomy Information

Taxonomy Code 320600000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

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1699285676 Antonio Romero Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1045 N Leithgow St, Philadelphia, PA 19123-1420 2017-10-04
1578007795 Rhonda Hill-sharif Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2932 N Taylor St, Philadelphia, PA 19132-1911 2016-12-06
1588039960 Holcomb Associates, Inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 4000 Presidential Blvd Apt 1101, Philadelphia, PA 19131-1720 2015-12-10
1205213832 Serene Services Inc Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1144 N 4th St, Philadelphia, PA 19123-1503 2015-05-04
1982931440 Vernon Care Living Inc Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 729 E Vernon Rd, Philadelphia, PA 19119-1502 2009-11-04
1578715959 Transion Stage Three Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 5602 Harley Dr Apt 2c, Philadelphia, PA 19143-6264 2008-10-16
1760517205 Eman Community Living Inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 820 E Vernon Rd Fl 2, Philadelphia, PA 19119-1519 2007-02-23
1073882296 Northeast Community Center for Mh/mr Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 4641 Roosevelt Blvd, Orleans Building, Philadelphia, PA 19124-2343 2011-12-16
1093995243 Resources for Human Development Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 4700 Wissahickon Ave, Philadelphia, PA 19144-4248 2007-11-05
Find all providers in PHILADELPHIA

Office Location

Street Address 4000 GYPSY LN UNIT 204
City PHILADELPHIA
State PA
Zip Code 19129-5405

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518325760 Care365 Inc Case Management 3507 Scotts Ln, Ste. 1923, Philadelphia, PA 19129 2016-02-03
1144698408 Raymond C Nwaneri Nurse Practitioner 3301 Scotts Lane, Haven Behavioral Hospital, Philadelphia, PA 19129 2015-09-03
1659748432 Donna S. Wolf Social Worker 3302 Tilden Street, Philadelphia, PA 19129 2015-08-27
1891066619 Melissa Sayer Advanced Practice Midwife 2450 W. Hunting Park Ave, Temple University Health System, Philadelphia, PA 19129 2012-01-25
1154604007 Keystone Psychological Associates Clinic/Center 3502 Scotts Lane, Building 1 Suite 114, Philadelphia, PA 19129 2011-09-27
1053633164 Deana Marie Bidey Psychiatry & Neurology 2900 Queen Lane, Philadelphia, PA 19129 2010-02-17
1174754618 Clarence B Iszard Jr. Counselor 3246 North Bailey Street, Philadelphia, PA 19129 2009-07-31
1487816708 St.chris Care At Northeast Pediatrics, LLC Pediatrics One Falls Center, 3300 Henry Avenue, 4th Floor, Philadelphia, PA 19129 2008-06-27
1740400845 Sharon L. Young Psychologist 3205 Defense Terrace, Abbottsford Family Practice & Counseling, Philadelphia, PA 19129 2007-04-30
1043355621 Donald Herman Silverman Dentist 3405 Warden Drive, Philadelphia, PA 19129 2007-02-21
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Competitor

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City PHILADELPHIA
Zip Code 19129

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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