| NPI | 1447294186 |
|---|---|
| Doing Business As | GPHA AL ASSIST 4TH ST |
| Entity Type | Organization |
| Authorized Contact | D TINA SMITH Provider Enrollment Spec. 215-925-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103T00000X Psychologist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 104100000X Social Worker | |
| 2080C0008X Pediatrics, Child Abuse Pediatrics | |
| 261Q00000X | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2017-03-15 |