Healthcare Provider Details

I. General information

NPI: 1528075611
Provider Name (Legal Business Name): GOOD FRIENDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

868 W. BRIDGE STREET
MORRISVILLE PA
19067-0165
US

IV. Provider business mailing address

PO BOX 165 868 W. BRIDGE STREET
MORRISVILLE PA
19067-0165
US

V. Phone/Fax

Practice location:
  • Phone: 215-736-2861
  • Fax: 215-736-1966
Mailing address:
  • Phone: 215-736-2861
  • Fax: 215-736-1966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number093259
License Number StatePA

VIII. Authorized Official

Name: MR. TED M. MILLARD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 215-736-2861