Organization
COMPLETE MIND CARE OF PA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDIE M MATTHEWS (DIRECTOR OF CRED & CONTRACTING)
(610) 763-9413
Entity
Organization
Contact information
Practice address
795 E LANCASTER AVE STE 210, VILLANOVA, PA 19085-1525
(215) 461-5760
(215) 754-1705
Mailing address
795 E LANCASTER AVE STE 210, VILLANOVA, PA 19085-1525
(215) 461-5760
(215) 754-1705
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/12/2023
Last updated
12/12/2023
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