Healthcare Provider Details

I. General information

NPI: 1306287941
Provider Name (Legal Business Name): INTERCULTURAL FAMILY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2317 S 23RD ST
PHILADELPHIA PA
19145-3329
US

IV. Provider business mailing address

4225 CHESTNUT ST
PHILADELPHIA PA
19104-3014
US

V. Phone/Fax

Practice location:
  • Phone: 215-468-4673
  • Fax: 215-468-4663
Mailing address:
  • Phone: 215-386-1298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCW015768
License Number StatePA

VIII. Authorized Official

Name: ANGELO ADSON
Title or Position: DIRECTOR BEHAVIORAL HEALTH
Credential: MSS, MLSP, MBA, LCSW
Phone: 215-468-4673