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General NPI Number Information
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NPI Number | 1124453303
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Entity Type | Organization
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Legal Business Name | QUALITY COMMUNITY HEALTH CARE, INC
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Dates
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Enumeration Date | 09/06/2013
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Last Update Date | 09/06/2013
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Provider Practice Location Address
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Address Line | 2501 W LEHIGH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19132-3207
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Country | US
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Telephone | 215-227-0300
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Fax | 215-227-0302
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Provider Business Mailing Address
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Address Line | 2501 W LEHIGH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19132
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Country | US
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Telephone | 215-227-0300
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Fax | 215-227-0302
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Authorized Official
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Title or Position | PROJECT MANAGER
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Name | ALYCIA DENNIS
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Credential |
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Telephone | 215-227-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW015375
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License Number State | PA
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