Organization
EAST PARK REVITALIZATION ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUKU JOHN (EXECUTIVE DIRECTOR)
(610) 291-2481
Entity
Organization
Contact information
Practice address
1737 N 31ST ST, PHILADELPHIA, PA 19121-2522
(610) 291-2481
Mailing address
1737 N 31ST ST, PHILADELPHIA, PA 19121-2522
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/08/2013
Last updated
03/08/2013
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