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325 N 39th St Philadelphia PA 19104-4656 | |
| (215) 382-7522 | |
| (215) 382-4405 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 325 N 39th 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 |
|---|---|
3801 Market St Suite 201 Philadelphia PA 19104-3153 Ph: (215) 596-8100 | 325 N 39th St Philadelphia PA 19104-4656 Ph: (215) 382-7522 |
| NPI Number | 1992822449 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992822449 | NPI | - | NPPES |
| 1007155230065 | Medicaid | PA |
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