| Rhd Lacasa | |
|
5050 Wynnefield Ave Apt. 106 Philadelphia PA 19131-2346 | |
| (215) 951-0300 | |
| Not Available |
| Full Name | Rhd Lacasa |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5050 Wynnefield Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Dyann M Roth (CEO) |
| Authorized Official Contact | 2159510300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rhd Lacasa 4700 Wissahickon Ave Suite 126 Philadelphia PA 19144-4248 Ph: (215) 951-0300 | Rhd Lacasa 5050 Wynnefield Ave Apt. 106 Philadelphia PA 19131-2346 Ph: (215) 951-0300 |
| NPI Number | 1205202835 |
|---|---|
| Provider Enumeration Date | 08/18/2015 |
| Last Update Date | 08/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205202835 | NPI | - | NPPES |
| 100001708 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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