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NPI 1528075611

NPI 1528075611 : GOOD FRIENDS, INC. : MORRISVILLE, PA

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General NPI Number Information
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    NPI Number           |    1528075611
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    Entity Type          |    Organization 
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    Legal Business Name  |    GOOD FRIENDS, INC. 
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Dates
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    Enumeration Date     |    08/02/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    868 W. BRIDGE STREET 
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    City                 |    MORRISVILLE
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    State                |    PA
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    Zip                  |    19067-0165
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    Country              |    US
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    Telephone            |    215-736-2861
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    Fax                  |    215-736-1966
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Provider Business Mailing Address
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    Address Line         |    PO BOX 165 868 W. BRIDGE STREET
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    City                 |    MORRISVILLE
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    State                |    PA
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    Zip                  |    19067-0165
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    Country              |    US
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    Telephone            |    215-736-2861
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    Fax                  |    215-736-1966
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Authorized Official
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    Title or Position    |    EXECUTIVE DIRECTOR
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    Name                 |    MR. TED M. MILLARD 
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    Credential           |    
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    Telephone            |    215-736-2861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    324500000X
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    Taxonomy Name        |    Substance Abuse Rehabilitation Facility
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    License Number       |    093259
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    License Number State |    PA
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