| NPI | 1780101691 |
|---|---|
| Doing Business As | BANYAN PHILADELPHIA |
| Entity Type | Organization |
| Authorized Contact | RENE MOLINA Director Of Credentialing & Contrac 954-533-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261QM0801X | |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2022-12-09 |