OrganizationActive
Intercommunity Action, Inc.
NPI 1407075245 · Intellectual Disabilities Intermediate Care Facility · Philadelphia, PA
Provider details
- NPI number
- 1407075245
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- David Bolin, Executive Director(215) 487-0906
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
2405 N 54th St
Philadelphia, PA 19131-2423
Phone: (215) 477-6661
Approximate (ZIP-level) locationGet directions
Mailing address
6012 Ridge Ave
Philadelphia, PA 19128-1643
Registry dates
- Enumerated
- 2007-04-24
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.