Organization
INTERCOMMUNITY ACTION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN COHEN (CEO/PRESIDENT)
(215) 487-0906
Entity
Organization
Contact information
Practice address
4030 BROWN ST, PHILADELPHIA, PA 19104-4844
(215) 487-0904
Mailing address
6012 RIDGE AVE, PHILADELPHIA, PA 19128-1643
(215) 487-0906
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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