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Organization
THE MEN'S RESOURCE CENTER
Active
Organization
THE MEN'S RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD BENJAMIN EVANS LCSW (DIRECTOR)
(215) 564-0488
Entity
Organization
Contact information
Practice address
1601 WALNUT ST, SUITE 1017, PHILADELPHIA, PA 19102-2944
(215) 564-0488
(215) 564-1245
Mailing address
1601 WALNUT ST, SUITE 1017, PHILADELPHIA, PA 19102-2944
(215) 564-0488
(215) 564-1245
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CWO12294
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012955860001
—
PA
Enumeration date
08/17/2006
Last updated
08/22/2020
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