| 9091 Representative Payee (philadelphia) | |
|
1211 Chestnut Street Floor 11 Philadelphia PA 19107 | |
| (215) 751-1800 | |
| (215) 636-6300 |
| Full Name | 9091 Representative Payee (philadelphia) |
|---|---|
| Speciality | Voluntary Or Charitable |
| Location | 1211 Chestnut Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Adriana Torres-o'connor (PRESIDENT AND CHIEF EXECUTIVE OFFIC) |
| Authorized Official Contact | 2157511800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 9091 Representative Payee (philadelphia) 1211 Chestnut Street Floor 11 Philadelphia PA 19107 Ph: (215) 751-1800 | 9091 Representative Payee (philadelphia) 1211 Chestnut Street Floor 11 Philadelphia PA 19107 Ph: (215) 751-1800 |
| NPI Number | 1134359904 |
|---|---|
| Provider Enumeration Date | 07/15/2009 |
| Last Update Date | 03/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134359904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251V00000X | Voluntary Or Charitable | (* (Not Available)) | Primary |
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