| |
166 W Main St Norristown PA 19401-4716 | |
(610) 279-4262 | |
(610) 278-1658 |
Full Name | |
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Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 166 W Main St, Norristown, Pennsylvania |
Authorized Official Name and Position | Mike Williams (CONTRACT MANAGER) |
Authorized Official Contact | 4843383731 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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106 W Main St Norristown PA 19401-4716 Ph: (610) 239-9600 | 166 W Main St Norristown PA 19401-4716 Ph: (610) 279-4262 |
NPI Number | 1700051356 |
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Provider Enumeration Date | 04/24/2008 |
Last Update Date | 05/18/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700051356 | NPI | - | NPPES |
1002285890109 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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