Organization
WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC.
Active
Other names
The Consortium Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN F WHITE JR. (PRESIDENT CEO)
(215) 596-8100
Entity
Organization
Contact information
Practice address
4300 WESTMINSTER AVE, PHILADELPHIA, PA 19104-1308
(215) 596-8100
(215) 382-4405
Mailing address
3801 MARKET ST, SUITE 201, PHILADELPHIA, PA 19104-3153
(215) 596-8100
(215) 382-4405
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
128620
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007155230064
—
PA
Enumeration date
03/23/2007
Last updated
08/22/2020
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