Organization
INTERCOMMUNITY ACTION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID BOLIN (CEO/PRESIDENT)
(215) 487-0906
Entity
Organization
Contact information
Practice address
67 E BRINGHURST ST, JOHN WISTER ELEMENTARY SCHOOL, PHILADELPHIA, PA 19144-2338
(215) 951-4003
Mailing address
6012 RIDGE AVE, PHILADELPHIA, PA 19128-1643
(215) 487-0906
(215) 487-3716
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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