| NPI | 1093859878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD BIRKELBACH Chief Executive Officer 215-345-8530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: PA FACILITYNUMBER092344) |
| Additional Taxonomies | 251S00000X (Licence: PA 092344) |
| 261Q00000X Clinic/Center (Licence: PA FACILITYNUMBER092344) | |
| 261QM2800X Clinic/Center, Methadone Clinic (Licence: PA FACILITYNUMBER092344) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2019-12-31 |