Organization
CHANGING YOUTH BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYHARA NELSON (OWNER)
(856) 203-1761
Entity
Organization
Contact information
Practice address
26 EGRET CIR, DENVER, PA 17517-9622
(856) 203-1761
Mailing address
701 E CATHEDRAL RD, PHILADELPHIA, PA 19128-2128
(856) 203-1761
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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