| Pennsylvania Mentor | |
|
450 Parkway Ste 200 Broomall PA 19008-4202 | |
| (484) 868-5813 | |
| Not Available |
| Full Name | Pennsylvania Mentor |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 450 Parkway Ste 200, Broomall, Pennsylvania |
| Authorized Official Name and Position | Brett Ian Cohen (COO) |
| Authorized Official Contact | 8003885150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennsylvania Mentor 313 Congress St Boston MA 02210-1218 Ph: (800) 388-5150 | Pennsylvania Mentor 450 Parkway Ste 200 Broomall PA 19008-4202 Ph: (484) 868-5813 |
| NPI Number | 1952989212 |
|---|---|
| Provider Enumeration Date | 03/30/2021 |
| Last Update Date | 03/19/2023 |
| Certification Date | 03/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952989212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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