Organization
TRANSION STAGE THREE
Active
Other names
mental heath
Organization subpart
No
Provider details
NPI number
Authorized official
NYESHA SMITH (MENTAL HEALTH WORKER)
(215) 833-2999
Entity
Organization
Contact information
Practice address
5602 HARLEY DR APT 2C, PHILADELPHIA, PA 19143-6264
(215) 833-2999
Mailing address
5602 HARLEY DR APT 2C, PHILADELPHIA, PA 19143-6264
(215) 833-2999
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/16/2008
Last updated
10/16/2008
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