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Organization
ST GABRIELS SYSTEM
Active
Organization
ST GABRIELS SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH LAVORITANO (EXECUTIVE DIRECTOR)
(215) 665-8777
Entity
Organization
Contact information
Practice address
227 N 18TH ST, PHILADELPHIA, PA 19103-1212
(215) 665-8777
Mailing address
227 N 18TH ST, PHILADELPHIA, PA 19103-1212
(215) 665-8777
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
125560
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007722800001
—
PA
Enumeration date
05/07/2008
Last updated
01/07/2016
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