Organization
CORECARE BEHAVIORAL HEALTH
Active
Other names
Kirkbride Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ROSE S DIOTTAVIO (PRESIDENT)
(215) 471-2853
Entity
Organization
Contact information
Practice address
111 N 49TH ST, PHILADELPHIA, PA 19139-2718
(215) 471-2488
Mailing address
111 N 49TH ST, PHILADELPHIA, PA 19139-2718
(215) 471-2488
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
197910
PA
273Y00000X
Rehabilitation Hospital Unit
807208
PA
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
807208
PA
283Q00000X
Psychiatric Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007737600004
—
PA
Enumeration date
07/15/2005
Last updated
10/22/2015
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