Organization
PHILA HEALTH MANAGEMENT CORP
Active
Organization
PHILA HEALTH MANAGEMENT CORP
Active
Other names
Prise-IOP
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTE PENNINGTON (BILLER)
(215) 731-2042
Entity
Organization
Contact information
Practice address
4329 GRISCOM ST, PHILA, PA 19124-3911
(215) 731-2042
Mailing address
260 S BROAD ST, 18TH FLOOR, PHILA, PA 19102-5021
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000016640044
—
PA
Enumeration date
06/06/2008
Last updated
07/25/2008
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