| Compassionate Care Center Llc | |
|
10151 Bustleton Ave Unit C Philadelphia PA 19116-3718 | |
| (215) 676-6393 | |
| Not Available |
| Full Name | Compassionate Care Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10151 Bustleton Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Polina Stolyarova (PRESIDENT) |
| Authorized Official Contact | 2156766393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compassionate Care Center Llc 10151 Bustleton Ave Unit C Philadelphia PA 19116-3718 Ph: () - | Compassionate Care Center Llc 10151 Bustleton Ave Unit C Philadelphia PA 19116-3718 Ph: (215) 676-6393 |
| NPI Number | 1518130335 |
|---|---|
| Provider Enumeration Date | 04/13/2008 |
| Last Update Date | 04/13/2008 |
| Medicare PECOS PAC ID | 9234208638 |
|---|---|
| Medicare Enrollment ID | O20080527000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518130335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MD418065 (Pennsylvania) | Primary |
| Provider Name | Polina Stolyarova |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043228216 PECOS PAC ID: 8224036017 Enrollment ID: I20061109000384 |
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