Organization
WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC
Active
Other names
The Consortium Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN F. WHITE JR. (PRESIDENT CEO)
(215) 596-8100
Entity
Organization
Contact information
Practice address
6408 WOODLAND AVE, PHILADELPHIA, PA 19142-2323
(215) 596-8100
(215) 382-4405
Mailing address
3801 MARKET ST, SUITE 201, PHILADELPHIA, PA 19104-3153
(215) 596-8100
(215) 382-4405
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1007155230045
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007155230045
—
PA
Enumeration date
03/30/2007
Last updated
08/22/2020
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