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General NPI Number Information
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NPI Number | 1346482841
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Entity Type | Organization
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Legal Business Name | ADVANCED BEHAVIORAL CARE
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 1223 N PROVIDENCE RD SUITE 3
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City | MEDIA
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State | PA
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Zip | 19063-1235
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Country | US
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Telephone | 610-565-1399
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Fax | 610-565-0688
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Provider Business Mailing Address
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Address Line | 1223 N PROVIDENCE RD SUITE 3
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City | MEDIA
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State | PA
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Zip | 19063-1235
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Country | US
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Telephone | 610-565-1399
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Fax | 610-565-0688
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Authorized Official
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Title or Position | DIRECTOR
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Name | PATRICK J. MCHUGH
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Credential | PH.D.
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Telephone | 610-565-1399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | PA
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