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18 E 4th St Bridgeport PA 19405-1460 | |
(484) 674-7698 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 18 E 4th St, Bridgeport, Pennsylvania |
Authorized Official Name and Position | Brian Matthew Rhodes (CEO) |
Authorized Official Contact | 2159510300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4700 Wissahickon Ave Suite 126 Philadelphia PA 19144-4248 Ph: (215) 951-0300 | 18 E 4th St Bridgeport PA 19405-1460 Ph: (484) 674-7698 |
NPI Number | 1164891271 |
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Provider Enumeration Date | 09/18/2015 |
Last Update Date | 06/20/2024 |
Certification Date | 06/17/2024 |
Identifier | Type | State | Issuer |
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1164891271 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |