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General NPI Number Information
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NPI Number | 1225576812
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Entity Type | Organization
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Legal Business Name | ACOLLECTIVE CONSULTING LLC
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 710 SPROUL ST
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City | CHESTER
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State | PA
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Zip | 19013-4209
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Country | US
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Telephone | 484-490-6944
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Fax | 484-482-6638
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Provider Business Mailing Address
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Address Line | PO BOX 1121
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City | BROOKHAVEN
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State | PA
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Zip | 19015-0121
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Country | US
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Telephone | 484-490-6944
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Fax | 484-482-6638
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Authorized Official
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Title or Position | CEO
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Name | BIGE MONYEA CHAMBERS SR.
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Credential |
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Telephone | 610-800-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number | 142430
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 142430
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License Number State | PA
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