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General NPI Number Information
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NPI Number | 1396990834
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Entity Type | Organization
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Legal Business Name | INTERACTIVE COMMUNICATION LLC
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 4000 PRESIDENTIAL BLVD #1202
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City | PHILADELPHIA
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State | PA
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Zip | 19131-1713
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Country | US
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Telephone | 215-913-7112
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 PRESIDENTIAL BOULEVARD #1202
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City | PHILADELPHIA
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State | PA
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Zip | 19131-1721
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Country | US
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Telephone | 215-913-7112
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. DEBORAH ANN FINLEY
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Credential | PH.D.
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Telephone | 215-913-7112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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