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General NPI Number Information
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NPI Number | 1134267214
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Entity Type | Organization
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Legal Business Name | JUNIATA COMMUNITY MENTAL HEALTH
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 2637-45 N. 5TH STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19133-0000
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Country | US
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Telephone | 215-291-0550
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Fax | 215-291-0566
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Provider Business Mailing Address
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Address Line | 2637-45 N. 5TH STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19133-0000
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Country | US
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Telephone | 215-291-0550
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Fax | 215-291-0566
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. ROLAND TURK
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Credential | MSW
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Telephone | 215-291-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 111780
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License Number State | PA
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