Organization
INRERCOMMUNITY 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
3401 N BROAD ST, TEMPLE CLINIC, PHILA, PA 19140-5103
(215) 487-1330
Mailing address
6012 RIDGE AVE, PHILA, 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
—
1000008360105
—
PA
Enumeration date
02/20/2007
Last updated
03/06/2008
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