Provider Demographics
NPI:1124159256
Name:PHILADELPHIA DEVELOPMENTAL DISABILITIES CORPORATION
Entity type:Organization
Organization Name:PHILADELPHIA DEVELOPMENTAL DISABILITIES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-229-4550
Mailing Address - Street 1:2350 W WESTMORELAND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-4718
Mailing Address - Country:US
Mailing Address - Phone:215-229-4550
Mailing Address - Fax:
Practice Address - Street 1:2350 W WESTMORELAND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-4718
Practice Address - Country:US
Practice Address - Phone:215-229-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services