Provider Demographics
NPI:1972355253
Name:PATELZ
Entity type:Organization
Organization Name:PATELZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEBBEH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLUWOI
Authorized Official - Suffix:
Authorized Official - Credentials:BS, BSN,RN
Authorized Official - Phone:610-506-0915
Mailing Address - Street 1:2007 KATER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1312
Mailing Address - Country:US
Mailing Address - Phone:610-506-0915
Mailing Address - Fax:
Practice Address - Street 1:923 RUE MADORA
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2545
Practice Address - Country:US
Practice Address - Phone:610-506-0915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services