Organization
NEW VITAE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN MUTH BA (DIRECTOR, PROJECT MANAGEMENT)
(610) 965-9021
Entity
Organization
Contact information
Practice address
27 S 55TH STREET, PHILADELPHIA, PA 19139
(267) 499-4299
(267) 713-7372
Mailing address
P.O. BOX 1001, 5201 ST JOSEPHS ROAD, LIMEPORT, PA 18060-0010
(610) 965-9021
(610) 928-0174
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
144110
PA
251S00000X
Community/Behavioral Health Agency
Primary
144110
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007458450
—
PA
Enumeration date
05/09/2016
Last updated
07/11/2018
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