Organization
BANYAN PHILADELPHIA, LLC
Active
Other names
Banyan Philadelphia
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SORY (CEO)
(954) 533-7705
Entity
Organization
Contact information
Practice address
100 N BUCKSTOWN RD STE 100, LANGHORNE, PA 19047-1875
(215) 249-6226
(267) 512-6053
Mailing address
225 N FEDERAL HWY, POMPANO BEACH, FL 33062-4319
(954) 533-7705
(954) 781-7173
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/23/2017
Last updated
08/12/2025
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