| Philadelphia Mental Health Clinic | |
|
1235 Pine St Philadelphia PA 19107-5945 | |
| (215) 735-9379 | |
| (215) 735-8806 |
| Full Name | Philadelphia Mental Health Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 1235 Pine St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Allen Anderson (DIRECTOR BILLING/PC SYSTEMS) |
| Authorized Official Contact | 2157355674 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philadelphia Mental Health Clinic 1235 Pine St Philadelphia PA 19107-5945 Ph: (215) 735-9379 | Philadelphia Mental Health Clinic 1235 Pine St Philadelphia PA 19107-5945 Ph: (215) 735-9379 |
| NPI Number | 1760644744 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 06/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760644744 | NPI | - | NPPES |
| 1007279540005 | Medicaid | PA | |
| 265050000 | Other | PA | MAGELLAN |
| 000138598 | Other | PA | BC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 123880 (Pennsylvania) | Primary |
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