DEEP ROOTS CHARTER SCHOOL; NPI #1245020254

Contact Information

DEEP ROOTS CHARTER SCHOOL

900 LINDLEY AVE
PHILADELPHIA, PA 19141-3920

Phone: 267-324-5707
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	School	363LS0200X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for DEEP ROOTS CHARTER SCHOOL

NPI Number	`1245020254`
LBN Legal business name	DEEP ROOTS CHARTER SCHOOL
Authorized official	KEANNA AUSTIN - (DORCM)
Entity	Organization
Organization subpart ¹	No
Enumeration date	05/12/2025
Last updated	05/12/2025 - More than a year ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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DEEP ROOTS CHARTER SCHOOL

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NPI Profile & details for DEEP ROOTS CHARTER SCHOOL

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