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General NPI Number Information
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NPI Number | 1477603678
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Entity Type | Organization
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Legal Business Name | SAINT GABRIEL'S SYSTEM
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 1350 PAWLINGS ROAD
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City | AUDUBON
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State | PA
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Zip | 19407-7280
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Country | US
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Telephone | 215-247-2776
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Fax | 610-666-1698
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Provider Business Mailing Address
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Address Line | 1350 PAWLINGS ROAD
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City | AUDUBON
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State | PA
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Zip | 19407-7280
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Country | US
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Telephone | 215-247-2776
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Fax | 610-666-1698
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOSEPH LAVORITANO
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Credential |
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Telephone | 215-665-8777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 139210
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License Number State | PA
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