| Interventive Care Crisis Management Network | |
|
3800 North Broad Street Philadelphia PA 19140 | |
| (215) 225-5566 | |
| (215) 949-3483 |
| Full Name | Interventive Care Crisis Management Network |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3800 North Broad Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Dennis Yates (PRESIDENT) |
| Authorized Official Contact | 2679947752 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Interventive Care Crisis Management Network 3800 N Broad St Fl 2 Philadelphia PA 19140-3610 Ph: (215) 225-5566 | Interventive Care Crisis Management Network 3800 North Broad Street Philadelphia PA 19140 Ph: (215) 225-5566 |
| NPI Number | 1013129709 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 12/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013129709 | NPI | - | NPPES |
| 0016910490001 | Other | PA | PROMISE MAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 102930 (Pennsylvania) | Primary |
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