Organization
CHILD GUIDANCE RESOURCE CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD JARGER CPA (DIRECTOR PI)
(484) 454-8735
Entity
Organization
Contact information
Practice address
2901 ISLAND AVE, PHILADELPHIA, PA 19153-3013
(484) 454-8735
Mailing address
2000 OLD WEST CHESTER PIKE, HAVERTOWN, PA 19083-2712
(484) 454-8700
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
112610
PA
251S00000X
Community/Behavioral Health Agency
Primary
112610
PA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
184890
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100005940
—
PA
05
—
112610
—
PA
Enumeration date
06/26/2013
Last updated
01/14/2016
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