| NPI | 1073512331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL RUSSO Corp. Director Of Finance 215-456-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: PA 117160) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: PA 121960) |
| 283Q00000X Psychiatric Hospital (Licence: PA 117160) | |
| 283Q00000X Psychiatric Hospital (Licence: PA 177920) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2020-08-22 |