Organization
GREATER PHILA HEALTH ACTION, INC.
Active
Other names
GPHA Al Assist 4th St
Organization subpart
No
Provider details
NPI number
Authorized official
MS. D TINA SMITH (PROVIDER ENROLLMENT SPEC.)
(215) 925-2400
Entity
Organization
Contact information
Practice address
1401 S. 4TH STREET, 4TH FLOOR, PHILADELPHIA, PA 19147-5948
(215) 339-1029
(215) 952-6966
Mailing address
1401 S. 31ST STREET, 2ND FLOOR, PHILADELPHIA, PA 19146-3506
(215) 925-2400
(215) 925-9162
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
2080C0008X
Child Abuse Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001374480022
—
PA
01
—
391935
MEDICARE ID
—
Enumeration date
06/15/2006
Last updated
03/15/2017
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