| NPI | 1518737824 |
|---|---|
| Doing Business As | ELLIE PA-HAVERTOWN-TOWNSHIP LINE RD |
| Entity Type | Organization |
| Authorized Contact | RICHARD F CUBBAGE Managing Member 267-784-5118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 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 |