| Community Council For Mh/mr, Inc. | |
|
4900 Wyalusing Ave Philadelphia PA 19131-5127 | |
| (215) 473-7033 | |
| (215) 473-5405 |
| Full Name | Community Council For Mh/mr, Inc. |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 4900 Wyalusing Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Earle Bradford (CEO) |
| Authorized Official Contact | 2154737033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Council For Mh/mr, Inc. 4900 Wyalusing Ave Philadelphia PA 19131-5127 Ph: (215) 473-7033 | Community Council For Mh/mr, Inc. 4900 Wyalusing Ave Philadelphia PA 19131-5127 Ph: (215) 473-7033 |
| NPI Number | 1649377003 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649377003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 121630 (Pennsylvania) | Primary |
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