| NPI | 1023177144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN O HASKELL Executive Director 215-701-1560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA 117040) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2025-02-24 |