Healthcare Provider Details

I. General information

NPI: 1487935805
Provider Name (Legal Business Name): BEBASHI TRANSITION TO HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 SPRING GARDEN ST
PHILADELPHIA PA
19123-3206
US

IV. Provider business mailing address

1235 SPRING GARDEN ST
PHILADELPHIA PA
19123-3206
US

V. Phone/Fax

Practice location:
  • Phone: 215-769-3561
  • Fax:
Mailing address:
  • Phone: 215-769-3561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. LIBRO JAMES CIARMATORI JR.
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 215-769-3561