OrganizationActive
Impactful Human Services LLC
NPI 1568072759 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Berwyn, PA
Provider details
- NPI number
- 1568072759
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Edwina Vanotoo, Office Manager(877) 500-4742
Specialties & taxonomies
Residential Treatment Facilities
Practice location
1055 Westlakes Dr Ste 300
Berwyn, PA 19312-2410
Phone: (877) 500-4742
Fax: (877) 500-4742
Approximate (ZIP-level) locationGet directions
Mailing address
1055 Westlakes Dr Ste 300
Berwyn, PA 19312-2410
Registry dates
- Enumerated
- 2020-08-03
- Last updated
- 2020-08-03
- Certified
- 2020-08-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.