Organization
CITYWIDE COMMUNITY COUNSELING SERVICES,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MODESTA MOLINA MD (CHIEF OF OPERATION)
(215) 291-9500
Entity
Organization
Contact information
Practice address
537 E ALLEGHENY AVE, APT/SUITE, PHILADELPHIA, PA 19134-2328
(215) 291-9500
Mailing address
537 E ALLEGHENY AVE, APT/SUITE, PHILADELPHIA, PA 19134-2328
(215) 291-9500
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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