Organization
NEW VITAE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN MUTH BA (DIRECTOR, PROJECT MANAGEMENT)
(610) 965-9021
Entity
Organization
Contact information
Practice address
1909 S 6TH ST, PHILADELPHIA, PA 19148-2452
(484) 270-9500
(215) 551-1382
Mailing address
16 S MAIN ST, QUAKERTOWN, PA 18951-1118
(215) 538-3403
(215) 538-3402
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007458450
—
PA
Enumeration date
05/10/2016
Last updated
05/23/2016
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