Organization
GREATER PHILA HEALTH ACTION, INC.
Active
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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