Organization
AVIVA MENTAL HEALTH SERVICES
Active
Other names
Aviva Mental Health Services, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSMARIA CHARLES MHS;CPSS (CLINICAL DIRECTOR)
(610) 522-4506
Entity
Organization
Contact information
Practice address
17 S MACDADE BLVD # 105, COLLINGDALE, PA 19023-1510
(610) 522-4506
(610) 522-4508
Mailing address
17 S MACDADE BLVD # 105, COLLINGDALE, PA 19023-1510
(610) 522-4506
(610) 522-4508
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
144120
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144120
—
PA
Enumeration date
06/06/2018
Last updated
06/06/2018
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