Organization
EELYSIUM BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VONTIA ANITA JONES M.S (OWNER/PRESIDENT)
(267) 266-2784
Entity
Organization
Contact information
Practice address
1441 W CAYUGA ST, PHILA, PA 19140-1934
(267) 266-2784
Mailing address
1441 W CAYUGA ST, PHILA, PA 19140-1934
(267) 266-2784
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
PA
253J00000X
Foster Care Agency
—
—
302F00000X
Exclusive Provider Organization
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
08/02/2012
Last updated
04/29/2014
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