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201 S. 18th Street 204 Philadelphia PA 19103-5919 | |
| (267) 702-4426 | |
| (215) 352-0410 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 201 S. 18th Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Michael Tyler Ramos (FOUNDER/ CEO) |
| Authorized Official Contact | 2677024426 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
201 S. 18th Street 204 Philadelphia PA 19103-5919 Ph: (267) 702-4426 | 201 S. 18th Street 204 Philadelphia PA 19103-5919 Ph: (267) 702-4426 |
| NPI Number | 1396105086 |
|---|---|
| Provider Enumeration Date | 02/24/2016 |
| Last Update Date | 04/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396105086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05708300 (New Jersey) | Primary |
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