| Kensington Hospital Inpatient Non-hospital Detoxification | |
|
136 Diamond St Philadelphia PA 19122-1721 | |
| (215) 426-8100 | |
| (215) 965-2344 |
| Full Name | Kensington Hospital Inpatient Non-hospital Detoxification |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 136 Diamond St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Eileen Hause (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2154268100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kensington Hospital Inpatient Non-hospital Detoxification 136 Diamond St Philadelphia PA 19122-1721 Ph: (215) 426-8100 | Kensington Hospital Inpatient Non-hospital Detoxification 136 Diamond St Philadelphia PA 19122-1721 Ph: (215) 426-8100 |
| NPI Number | 1144378530 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 02/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144378530 | NPI | - | NPPES |
| 1007717290016 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 860231 (Pennsylvania) | Primary |
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