Organization
INTERCOMMUNITY ACTION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHRONDA PETERSON (IT CONSULTANT)
(610) 389-9149
Entity
Organization
Contact information
Practice address
6012 RIDGE AVE, PHILADELPHIA, PA 19128
(215) 487-0906
(215) 487-3716
Mailing address
6012 RIDGE AVE, PHILADELPHIA, PA 19128-1643
(610) 389-9149
(215) 487-3716
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000008360071
—
PA
Enumeration date
02/21/2008
Last updated
12/07/2021
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