MEDICARE: CENTERPOINT HEALTHCARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1861980187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERPOINT HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	7042 ELMWOOD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19142-1722
Country	:	US
Telephone Number	:	215-937-0700
Fax Number	:

Provider Business Practice Location Address
First Line	:	7042 ELMWOOD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19142-1722
Country	:	US
Telephone Number	:	215-937-0700
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. BIYI OYEFULE
Credential	:	MD
Telephone Number	:	215-937-0700

Provider Enumeration Date	:	04/23/2018
Last Update Date	:	04/23/2018

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