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Organization
DR WARREN E SMITH COMMUNITY MENTAL HEALTH MENTAL RETARDATION & SUBSTAN
Active
Organization
DR WARREN E SMITH COMMUNITY MENTAL HEALTH MENTAL RETARDATION & SUBSTAN
Active
Other names
Dr Warren E Smith Health Centers WES Health Centers
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH GLASS PHD (CHIEF EXECUTIVE OFFICER)
(267) 256-0636
Entity
Organization
Contact information
Practice address
1315 WINDRIM AVENUE, PHILADELPHIA, PA 19141-2710
(215) 456-2611
(215) 456-2729
Mailing address
1315 WINDRIM AVENUE, DR WARREN E SMITH HEALTH CENTERS, PHILADELPHIA, PA 19141-2710
(215) 456-2611
(215) 456-2729
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
185300
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0561531000
PERSONAL CHOICE
PA
05
—
1000028030022
—
PA
05
—
1000028030027
—
PA
05
—
1000028030029
—
PA
05
—
1000028030045
—
PA
05
—
1000028030047
—
PA
05
—
1000028031004
—
PA
01
—
1317149
MAGELLAN BEHAV HEALTH
PA
01
—
3136579
AETNA US HEALTHCARE
PA
Enumeration date
08/15/2006
Last updated
08/22/2020
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