Organization
SHARED VALUES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHIANA SHARP (CEO)
(267) 247-2187
Entity
Organization
Contact information
Practice address
17 LARKSPUR LN, COLLEGEVILLE, PA 19426-3931
(267) 247-2187
Mailing address
17 LARKSPUR LN, COLLEGEVILLE, PA 19426-3931
(267) 247-2187
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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