Organization
3300 HENRY AVENUE OPERATING COMPANY, LP
Active
Other names
Pediatric Specialty Care at Philadelphia
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY KENWORTHY (SR. DIRECTOR REVENUE CYCLE MGMT)
(716) 361-6636
Entity
Organization
Contact information
Practice address
3300 HENRY AVE, PHILADELPHIA, PA 19129-1121
(215) 297-5555
Mailing address
500 SENECA ST STE 100, BUFFALO, NY 14204-1963
(716) 361-6636
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
08/01/2013
Last updated
09/23/2024
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