| Jefferson Integrated Behavioral Health | |
|
9501 Roosevelt Blvd Ste 206b Philadelphia PA 19114-1027 | |
| (215) 671-8900 | |
| (215) 671-1272 |
| Full Name | Jefferson Integrated Behavioral Health |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 9501 Roosevelt Blvd Ste 206b, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Ronald Kumor (SENIOR VICE PRESIDENT) |
| Authorized Official Contact | 2156124858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Integrated Behavioral Health Po Box 825395 Philadelphia PA 19182-5395 Ph: (215) 481-4790 | Jefferson Integrated Behavioral Health 9501 Roosevelt Blvd Ste 206b Philadelphia PA 19114-1027 Ph: (215) 671-8900 |
| NPI Number | 1023621471 |
|---|---|
| Provider Enumeration Date | 08/26/2020 |
| Last Update Date | 10/12/2022 |
| Certification Date | 10/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023621471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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