| Shalom Inc | |
|
1080 N Delaware Ave Suite 602 Philadelphia PA 19125-4330 | |
| (215) 425-7727 | |
| (215) 425-7785 |
| Full Name | Shalom Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1080 N Delaware Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Madeleine Boyd (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2154257727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shalom Inc 1080 N Delaware Ave Philadelphia PA 19125-4330 Ph: (215) 425-7727 | Shalom Inc 1080 N Delaware Ave Suite 602 Philadelphia PA 19125-4330 Ph: (215) 425-7727 |
| NPI Number | 1215199690 |
|---|---|
| Provider Enumeration Date | 06/27/2008 |
| Last Update Date | 06/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215199690 | NPI | - | NPPES |
| 119070 | Other | PA | CBH D/A OUTPATIENT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 109860 (Pennsylvania) | Primary |
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