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General NPI Number Information
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NPI Number | 1548550148
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Entity Type | Organization
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Legal Business Name | THE ARK OF PHILADELPHIA
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Dates
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Enumeration Date | 04/15/2011
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 5225 GERMANTOWN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19144-2301
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Country | US
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Telephone | 215-225-5437
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Fax | 215-229-3361
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Provider Business Mailing Address
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Address Line | 3843 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-3609
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Country | US
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Telephone | 215-225-5437
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. CECIL A HANKINS
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Credential |
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Telephone | 215-225-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 807416
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License Number State | PA
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