Organization
AVIVA MENTAL HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSMARIA CHARLES (DIRECTOR)
(610) 522-4506
Entity
Organization
Contact information
Practice address
320 MACDADE BLVD STE 205, COLLINGDALE, PA 19023-1926
(610) 522-4506
(610) 522-4508
Mailing address
320 MACDADE BLVD STE 205, COLLINGDALE, PA 19023-1926
(610) 522-4506
(610) 522-4508
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083110605
—
PA
Enumeration date
02/11/2021
Last updated
02/11/2021
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