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General NPI Number Information
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NPI Number | 1407909088
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Entity Type | Organization
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Legal Business Name | HALL-MERCER CMH-MRC OF PENNSYLVANIA HOSP
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 245 S 8TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106-3520
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Country | US
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Telephone | 215-796-4640
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Fax | 609-770-7792
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Provider Business Mailing Address
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Address Line | 245 S 8TH ST
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City | PHILA
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State | PA
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Zip | 19106-3520
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Country | US
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Telephone | 215-796-4640
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Fax | 609-770-7792
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. THOMAS MCCORMICK
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Credential |
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Telephone | 215-796-4640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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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