Organization
JOSEPH J. PETERS INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN O HASKELL PH.D. (EXECUTIVE DIRECTOR)
(215) 701-1560
Entity
Organization
Contact information
Practice address
100 SOUTH BROAD STREET, 17TH FLOOR, PHILADELPHIA, PA 19110
(215) 701-1560
(215) 701-1572
Mailing address
100 SOUTH BROAD STREET, 17TH FLOOR, PHILADELPHIA, PA 19110
(215) 701-1560
(215) 701-1572
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
117040
PA
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007562120008
—
PA
Enumeration date
12/06/2006
Last updated
02/24/2025
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