Organization
THERAPY 4 ABUNDANT LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY LYNN GREENE M.ED (CEO)
(267) 348-9263
Entity
Organization
Contact information
Practice address
579 VAN KIRK ST, PHILADELPHIA, PA 19120-1232
(267) 348-9263
Mailing address
6505 MARKET ST STE 103-383, UPPER DARBY, PA 19082-1809
(267) 348-9263
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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