Organization
MERAKEY IDD PHILADELPHIA
Active
Other names
The Association For Independent Growth, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN E TILSON JR. (CORP SR. DIRECTOR OF BUSINESS OPS)
(215) 836-3131
Entity
Organization
Contact information
Practice address
6901 OLD YORK RD APT D201, PHILADELPHIA, PA 19126-2228
(215) 224-7974
(215) 320-2041
Mailing address
4700 WISSAHICKON AVE, SUITE 100, PHILADELPHIA, PA 19144-4248
(215) 320-2040
(215) 320-2041
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
126430
PA
Other
Enumeration date
12/17/2007
Last updated
04/19/2018
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