Organization
WEST PHILADELPHIA COMMUNITY MENTAL HEALTH CONSORTIUM
Active
Other names
The Consotium Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN F WHITE JR. (PRESIDENT/CEO)
(215) 596-8100
Entity
Organization
Contact information
Practice address
111 N 49TH ST, EARLY INTERVENTION PROGRAM, PHILADELPHIA, PA 19139-2718
(215) 596-8100
(215) 382-4405
Mailing address
111 N 49TH ST, EARLY INTERVENTION PROGRAM, PHILADELPHIA, PA 19139-2718
(215) 596-8100
(215) 382-4405
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007155230001
—
PA
Enumeration date
05/18/2010
Last updated
05/18/2010
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