| Ellie Pa-havertown-township Line Rd | |
|
1120 W Township Line Rd Ste 101 Havertown PA 19083-4930 | |
| (267) 784-5118 | |
| Not Available |
| Full Name | Ellie Pa-havertown-township Line Rd |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1120 W Township Line Rd Ste 101, Havertown, Pennsylvania |
| Authorized Official Name and Position | Richard F Cubbage (MANAGING MEMBER) |
| Authorized Official Contact | 2677845118 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Pa-havertown-township Line Rd 8330 Fenton Rd Glenside PA 19038-7146 Ph: (267) 784-5118 | Ellie Pa-havertown-township Line Rd 1120 W Township Line Rd Ste 101 Havertown PA 19083-4930 Ph: (267) 784-5118 |
| NPI Number | 1518737824 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 04/29/2024 |
| Certification Date | 04/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518737824 | NPI | - | NPPES |
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