| The Consortium Inc. | |
|
26 S 40th St Philadelphia PA 19104-3009 | |
| (215) 596-8300 | |
| (215) 382-4405 |
| Full Name | The Consortium Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 26 S 40th St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | John F White (PRESIDENT CEO) |
| Authorized Official Contact | 2155968100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Consortium Inc. 3801 Market St Suite 201 Philadelphia PA 19104-3153 Ph: (215) 596-8100 | The Consortium Inc. 26 S 40th St Philadelphia PA 19104-3009 Ph: (215) 596-8300 |
| NPI Number | 1053438390 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053438390 | NPI | - | NPPES |
| 1007155230068 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 128620 (Pennsylvania) | Primary |
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