Organization
YALE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT SARAFINAS (DIRECTOR)
(610) 527-3411
Entity
Organization
Contact information
Practice address
4700 WISSAHICKON AVE, PHILA, PA 19144-4248
(215) 951-0300
(215) 951-0312
Mailing address
1029 COUNTY LINE RD, BRYN MAWR, PA 19010-2601
(610) 527-3411
(610) 527-6509
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000017080180
—
PA
Enumeration date
12/11/2006
Last updated
08/22/2020
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