| Community Council | |
|
1500 W Ontario St Philadelphia PA 19140-5012 | |
| (215) 228-4412 | |
| (215) 227-8778 |
| Full Name | Community Council |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1500 W Ontario St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | James Paige (CHIEF INFORMATION OFFICER) |
| Authorized Official Contact | 2154737033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Council 4900 Wyalusing Ave Philadelphia PA 19131-5127 Ph: (215) 473-7033 | Community Council 1500 W Ontario St Philadelphia PA 19140-5012 Ph: (215) 228-4412 |
| NPI Number | 1023231370 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 04/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023231370 | NPI | - | NPPES |
| 1000049600029 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 121630 (Pennsylvania) | Primary |
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