Organization
PHILADELPHIA HEALTH MANAGEMENT CORPORATION (PHMC) / GIRLSPACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTE PENNINGTON (BILLING COORDINATOR)
(215) 731-2042
Entity
Organization
Contact information
Practice address
111 N 49TH ST # 222, 2ND FL, SOUTH BLDG., PHILA, PA 19139-2718
(215) 731-2042
Mailing address
111 N 49TH ST # 222, 2ND FL, SOUTH BLDG., PHILA, PA 19139-2718
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000016640048
—
PA
Enumeration date
03/07/2008
Last updated
08/05/2008
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