Organization
CHILDREN'S CRISIS TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTONIO VALDES (EXECUTIVE DIRECTOR)
(215) 496-0707
Entity
Organization
Contact information
Practice address
1080 N DELAWARE AVE, SUITE 600, PHILADELPHIA, PA 19125-4330
(215) 496-0707
(215) 496-0742
Mailing address
1080 N DELAWARE AVE, SUITE 600, PHILADELPHIA, PA 19125-4330
(215) 496-0707
(215) 496-0742
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
121850
PA
251S00000X
Community/Behavioral Health Agency
139510
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100761197
—
PA
Enumeration date
12/12/2006
Last updated
03/18/2015
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