Healthcare Provider Details

I. General information

NPI: 1063637643
Provider Name (Legal Business Name): COMHAR, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 E ALLEGHENY AVE
PHILADELPHIA PA
19134-3832
US

IV. Provider business mailing address

100 W LEHIGH AVE
PHILADELPHIA PA
19133-4039
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-5800
  • Fax:
Mailing address:
  • Phone: 215-203-3000
  • Fax: 215-203-3089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MATHEW ELAVUMKAL
Title or Position: CEO
Credential:
Phone: 215-203-3000