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Organization

INTERCOMMUNITY ACTION, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID BOLIN (CEO/PRESIDENT)
(215) 487-0906
Entity
Organization

Contact information

Practice address
6100 STENTON AVE, PHILADELPHIA, PA 19138-1625
(215) 487-1320
Mailing address
6012 RIDGE AVE, PHILADELPHIA, PA 19128-1643
(215) 487-0906
(215) 487-3716

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000008361087
PA
Enumeration date
08/05/2013
Last updated
02/25/2014
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