FORGET ME KNOT YOUTH SERVICES (NPI# 1518407519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518407519 |
| Entity Type | Organization |
| Organization Name | FORGET ME KNOT YOUTH SERVICES |
| Practice Address |
2321 N Broad Street Philadelphia PA 19132 |
| Practice Telephone | 2157581153 |
| Mailing Telephone | 2157581153 |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2017-02-24 |
| Authorized Official Name | QUINZELLE BETHEA (DIRECTOR) |
| Authorized Official Telephone | 2157581153 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FORGET ME KNOT YOUTH SERVICES | 2321 N Broad St, Philadelphia, PA 19132 |
| Street Address |
2321 N BROAD STREET |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811511017 | Irene Maria Clark | Social Worker | 3101 N. 29th St., Philadelphia, PA 19132 | 2020-06-03 |
| 1609322437 | Shaakira Gillette | Social Worker | 2514 N. Broad St, Philadelphia, PA 19132 | 2016-08-31 |
| 1578017042 | Education Plus, Inc. | Nurse Practitioner | 3217 W. Clearfield Street, Philadelphia, PA 19132 | 2016-08-12 |
| 1972958544 | Rittenhouse Health LLC | Substance Abuse Rehabilitation Facility | 2321 N. Broad St, Philadelphia, PA 19132 | 2016-05-02 |
| 1336593458 | Jamal Vann | Counselor | 2233-43 West Allegheny Avenue, Philadelphia, PA 19132 | 2016-04-14 |
| 1487027132 | Jazzmin Devine | Specialist/Technologist | 200 Prospect St Hemlock 430a, East Stroudsburg University, PA 19132 | 2015-11-03 |
| 1609282508 | Lawrence Petitfrere | Pharmacist | 2801 W Dauphin St, Philadelphia, PA 19132 | 2014-07-11 |
| 1437565157 | Mental Health Partnerships | Community/Behavioral Health | 2709 N. Broad Street, Philadelphia, PA 19132 | 2014-07-02 |
| 1477977346 | Randy Morman | Counselor | 2514 N. Broad Street, 1st Floor, Philadelphia, PA 19132 | 2014-02-12 |
| 1568886778 | U-health Pharmacy Inc. | Pharmacy | 2704-6 W Allegheny Ave., Philadelphia, PA 19132 | 2014-02-07 |
| Find all providers in zip 19132 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639622681 | Cosmological LLC | Residential Treatment Facility, Emotionally Disturbed Children | 5746 N 19th St, Philadelphia, PA 19141-1204 | 2016-07-26 |
| 1184073645 | New Beginings LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2732 N 22nd St, Philadelphia, PA 19132-2601 | 2016-06-06 |
| 1861540932 | St. Vincent's Tacony | Residential Treatment Facility, Emotionally Disturbed Children | 7201 Milnor St, Philadelphia, PA 19135-1524 | 2007-01-08 |
| 1265608459 | St Gabriels System | Residential Treatment Facility, Emotionally Disturbed Children | 227 N 18th St, Philadelphia, PA 19103-1212 | 2008-05-07 |
| 1982763017 | Westmeade Center | Residential Treatment Facility, Emotionally Disturbed Children | 111 N 49th St, Philadelphia, PA 19139-2718 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376028860 | Woods Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 16 Lakeshore Drive, Langhorne, PA 19047-1616 | 2018-10-01 |
| 1861971665 | Woods Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 16 Woodlands Drive, Langhorne, PA 19047-1616 | 2018-08-13 |
| 1487133286 | Woods Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 19 Sandalwood Circle, Langhorne, PA 19047-1616 | 2018-08-13 |
| 1821592270 | Woods Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 357 Roebling Drive, Langhorne, PA 19047-1616 | 2018-03-21 |
| 1184127722 | Woods Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 17 Woodlands Drive, Langhorne, PA 19047 | 2018-03-09 |
| 1235632977 | Woods Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 84 Buttonwood Drive, Langhorne, PA 19047-0036 | 2018-03-08 |
| 1295286615 | Chor Youth and Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1023 Pear Street, Reading, PA 19601 | 2016-10-20 |
| 1871905380 | Woods Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 12 Foxwood Drive, Langhorne, PA 19047-0036 | 2014-06-02 |
| 1780096297 | Woods Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 15 Foxwood Drive, Langhorne, PA 19047-1616 | 2014-06-02 |
| 1245669126 | Woods Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 24 Elmwood Drive, Langhorne, PA 19047 | 2013-11-01 |
| Find all providers with the same taxonomy | ||||
| City | PHILADELPHIA |
| Zip Code | 19132 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.