| Intercommunity Action, Inc. | |
|
481 Krams Ave Philadelphia PA 19128-3311 | |
| (215) 509-1900 | |
| Not Available |
| Full Name | Intercommunity Action, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 481 Krams Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | David Bolin (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2154870906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intercommunity Action, Inc. 6012 Ridge Ave Philadelphia PA 19128-1643 Ph: (215) 487-0906 | Intercommunity Action, Inc. 481 Krams Ave Philadelphia PA 19128-3311 Ph: (215) 509-1900 |
| NPI Number | 1124162201 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 03/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124162201 | NPI | - | NPPES |
| 1000008360051 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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