Organization
HOSANNA MINISTRIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DESMOND MAUL (EXECUTIVE DIRECTOR)
(215) 221-4188
Entity
Organization
Contact information
Practice address
1600 W HUNTING PARK AVE, PHILADELPHIA, PA 19140-2900
(215) 221-4188
Mailing address
PO BOX 38152, PHILADELPHIA, PA 19140-0152
(215) 221-4188
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MFT000266
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AETNA
PSYCHOLOGICAL SERVICES
PA
01
—
HIGHMARK
PSYCHOLOGICAL SERVICES
PA
01
—
PERSONNALCHOICE
PSYCHOLOGICAL SERVICES
PA
01
—
UNITED HEALTHCARE
PSYCHOLOGICAL SERVICES
—
Enumeration date
12/22/2006
Last updated
08/22/2020
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