Organization
PHILADELPHIA MENTAL HEALTH CLINIC
Active
Other names
Phi9ladelphia Mental Health Clinic - BHRS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLEN ANDERSON (DIRECTOR, BILLING AND PC SYSTEMS)
(215) 735-9379
Entity
Organization
Contact information
Practice address
1235 PINE ST, PHILADELPHIA, PA 19107-5945
(215) 735-9379
(215) 732-8199
Mailing address
1235 PINE ST, PHILADELPHIA, PA 19107-5945
(215) 735-9379
(215) 732-8199
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
123880
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007279540001
—
PA
01
—
265050000
MAGELLAN PAHC
PA
Enumeration date
04/03/2007
Last updated
08/22/2020
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