Organization
INTERCOMMUNITY ACTION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BOLIN (EXECUTIVE DIRECTOR)
(215) 487-0906
Entity
Organization
Contact information
Practice address
481 KRAMS AVE, PHILADELPHIA, PA 19128-3311
(215) 509-1900
Mailing address
6012 RIDGE AVE, PHILADELPHIA, PA 19128-1643
(215) 487-0906
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000008360051
—
PA
Enumeration date
02/20/2007
Last updated
03/07/2008
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