Organization
COMMUNITY COUNCIL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REKIYA BELL (DIRECTOR OF UM/BILLING)
(215) 473-7033
Entity
Organization
Contact information
Practice address
4900 WYALUSING AVE, PHILADELPHIA, PA 19131-5127
(215) 473-7033
(215) 827-5276
Mailing address
4900 WYALUSING AVE, PHILADELPHIA, PA 19131-5127
(215) 473-7033
(215) 827-5276
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
121630
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000049600003
—
PA
Enumeration date
04/29/2008
Last updated
04/29/2008
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