Provider Demographics
NPI:1306111091
Name:CLEAR FOUNDATION
Entity type:Organization
Organization Name:CLEAR FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RALPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:484-472-7430
Mailing Address - Street 1:21 ORIOLE WAY
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1335
Mailing Address - Country:US
Mailing Address - Phone:484-472-7430
Mailing Address - Fax:484-472-7718
Practice Address - Street 1:1338 BRISTOL PIKE
Practice Address - Street 2:ONE WOODHAVEN SUITE 205
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5679
Practice Address - Country:US
Practice Address - Phone:484-472-7430
Practice Address - Fax:484-472-7718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty