| New Vitae Inc | |
|
5646 Walnut Street Philadelphia PA 19139-3920 | |
| (610) 965-9021 | |
| (215) 472-6580 |
| Full Name | New Vitae Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5646 Walnut Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Joan Muth (DIRECTOR, PROJECT MANAGEMENT) |
| Authorized Official Contact | 6109659021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Vitae Inc 16 S Main St Quakertown PA 18951-1118 Ph: (215) 538-3403 | New Vitae Inc 5646 Walnut Street Philadelphia PA 19139-3920 Ph: (610) 965-9021 |
| NPI Number | 1629529086 |
|---|---|
| Provider Enumeration Date | 10/20/2016 |
| Last Update Date | 11/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629529086 | NPI | - | NPPES |
| 1007458450 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
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