Organization
PROACTIVE SUPPORT COORDINATION AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ABOUBAKAR SIDIKI SYLLA (CEO)
(215) 880-5076
Entity
Organization
Contact information
Practice address
4949 FRANKFORD AVE, PHILADELPHIA, PA 19124-2669
(215) 613-6290
Mailing address
3019 S 68TH ST, PHILADELPHIA, PA 19142-3321
(215) 880-5076
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/03/2015
Last updated
07/03/2015
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