Healthcare Provider Details

I. General information

NPI: 1235003781
Provider Name (Legal Business Name): TREAT MENTAL HEALTH PENNSYLVANIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 CHESTNUT ST # 9
PHILADELPHIA PA
19106-3009
US

IV. Provider business mailing address

2915 RED HILL AVE STE A210C
COSTA MESA CA
92626-7979
US

V. Phone/Fax

Practice location:
  • Phone: 949-506-6162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EMILY HINSON
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 949-506-6162