Healthcare Provider Details

I. General information

NPI: 1851745566
Provider Name (Legal Business Name): KENSINGTON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N FRONT ST
PHILADELPHIA PA
19122-1705
US

IV. Provider business mailing address

2100 N FRONT ST
PHILADELPHIA PA
19122-1705
US

V. Phone/Fax

Practice location:
  • Phone: 215-426-8100
  • Fax: 267-861-6410
Mailing address:
  • Phone: 215-426-8100
  • Fax: 267-861-6410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number StatePA

VIII. Authorized Official

Name: KATHLEEN LALLI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MSN, RN
Phone: 215-426-8100