Organization
CORECARE BEHAVIORAL HEALTH MANAGEMENT, INC.
Active
Other names
Kirkbride Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ROSE DIOTTAVIO (PRESIDENT/CEO)
(215) 471-2358
Entity
Organization
Contact information
Practice address
111 N 49TH ST, PHILADELPHIA, PA 19139-2718
(215) 471-2687
(215) 471-2845
Mailing address
111 N 49TH ST, PHILADELPHIA, PA 19139-2718
(215) 471-2687
(215) 471-2845
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007737600002
—
PA
Enumeration date
06/03/2008
Last updated
01/13/2020
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