Organization
CENTER CITY RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE DORELIEN (MANAGER)
(215) 398-5304
Entity
Organization
Contact information
Practice address
1880 JFK BLVD STE 1110, PHILADELPHIA, PA 19103-7422
(215) 398-5304
Mailing address
1880 JFK BLVD STE 1110, PHILADELPHIA, PA 19103-7422
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
807440
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
807440
CERTIFICATE OF LICENSURE
PA
Enumeration date
05/30/2017
Last updated
06/11/2019
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