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Organization

COSMOLOGICAL LLC

Active
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Organization

COSMOLOGICAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CLYDE SANDERS (OWNER)
(215) 771-1819
Entity
Organization

Contact information

Practice address
5746 N 19TH ST, PHILADELPHIA, PA 19141-1204
(215) 771-1819
(215) 277-7227
Mailing address
5746 N 19TH ST, PHILADELPHIA, PA 19141-1204
(215) 771-1819
(215) 277-7227

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—

Other

Enumeration date
07/26/2016
Last updated
07/26/2016
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