Organization
SHALOM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADELEINE BOYD (EXECUTIVE DIRECTOR)
(215) 425-7727
Entity
Organization
Contact information
Practice address
1080 N DELAWARE AVE, SUITE 602, PHILADELPHIA, PA 19125-4330
(215) 425-7727
(215) 425-7785
Mailing address
1080 N DELAWARE AVE, PHILADELPHIA, PA 19125-4330
(215) 425-7727
(215) 425-7785
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
109860
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119070
CBH D/A OUTPATIENT
PA
Enumeration date
06/27/2008
Last updated
06/27/2008
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