NPI 1326684010
Active Community Support
Practice location
- Address
- 3505 W Moreland Rd, Willow Grove, PA 19090-3831
- Phone
- (484) 350-0075
Authorised official
- Name
- Charles K Nyaga
- Title
- Executive Director
- Phone
- (484) 350-0075
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1326684010
- Entity type
- Organization
- NPI issued
- 18 Nov 2019
- Record last updated
- 18 Nov 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.