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General NPI Number Information
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NPI Number | 1043656085
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Entity Type | Organization
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Legal Business Name | HOLCOMB BEHAVIORAL HEALTH SYSTEMS
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 110 DELAWARE AVE
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City | RIDLEY PARK
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State | PA
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Zip | 19078-1620
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Country | US
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Telephone | 610-363-1488
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Fax |
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Provider Business Mailing Address
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Address Line | 467 CREAMERY WAY
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City | EXTON
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State | PA
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Zip | 19341-2508
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Country | US
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Telephone | 610-363-1488
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Fax |
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Authorized Official
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Title or Position | COO
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Name | WILLIAM DIFABIO
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Credential |
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Telephone | 610-363-1488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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