| NPI | 1518737824 |
|---|---|
| Doing Business As | ELLIE PA-HAVERTOWN-TOWNSHIP LINE RD |
| Doing Business As | ELLIE MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | RICHARD F CUBBAGE Managing Member 267-784-5118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-04-29 |