Yahya Abdur Rahman

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Philadelphia, PA

NPI 1992437388 · NPPES record last updated Jun 26, 2022

Key facts

NPI
1992437388
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Practice address
1805 Roselyn St Rear Suite
Philadelphia, PA 19141-1331
Phone
(215) 694-9737
NPI assigned
Jun 26, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

1805 Roselyn St Rear Suite
Philadelphia, PA 19141-1331

Mailing address

1805 Roselyn St Rear Suite
Philadelphia, PA 19141-1331
Phone (215) 694-9737

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Pennsylvania

Sources for this page

Verify at the official NPI Registry.