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General NPI Number Information
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NPI Number | 1083164453
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Entity Type | Organization
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Legal Business Name | TABOR CHILDREN'S SERVICES
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 10/10/2016
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Provider Practice Location Address
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Address Line | 57 E ARMAT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19144-2201
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Country | US
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Telephone | 215-842-4800
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Fax | 215-842-4809
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Provider Business Mailing Address
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Address Line | 57 E ARMAT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19144-2201
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Country | US
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Telephone | 215-842-4800
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Fax | 215-842-4809
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Authorized Official
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Title or Position | CIO
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Name | DR. ROBERT EDWARD HAUSSMANN
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Credential | PHD
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Telephone | 215-842-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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