Healthcare Provider Details

I. General information

NPI: 1619375458
Provider Name (Legal Business Name): URBAN AFFAIRS COALITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2014
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2532 N BROAD ST ODAAT
PHILADELPHIA PA
19132-4013
US

IV. Provider business mailing address

1207 CHESTNUT ST
PHILADELPHIA PA
19107-4131
US

V. Phone/Fax

Practice location:
  • Phone: 215-226-7860
  • Fax:
Mailing address:
  • Phone: 215-851-0110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: SHARMAIN MATLOCK-TURNER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 215-851-1701