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100 Ross Rd Suite 204 King Of Prussia PA 19406-2110 | |
| (484) 681-4040 | |
| (484) 681-9734 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 100 Ross Rd, King Of Prussia, Pennsylvania |
| Authorized Official Name and Position | Brian Matthew Rhodes (CEO) |
| Authorized Official Contact | 2159510300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4700 Wissahickon Ave Suite 126 Philadelphia PA 19144-4248 Ph: (215) 951-0300 | 100 Ross Rd Suite 204 King Of Prussia PA 19406-2110 Ph: (484) 681-4040 |
| NPI Number | 1528335460 |
|---|---|
| Provider Enumeration Date | 11/21/2011 |
| Last Update Date | 06/17/2024 |
| Certification Date | 06/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528335460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 467113 (Pennsylvania) | Primary |
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