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General NPI Number Information
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NPI Number | 1578804019
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Entity Type | Organization
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Legal Business Name | ACHIEVING CITIZENS ACADEMY
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 1001 CITY AVE EC 911
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City | WYNNEWOOD
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State | PA
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Zip | 19096-3902
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Country | US
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Telephone | 267-449-9432
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Fax | 610-645-5414
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Provider Business Mailing Address
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Address Line | 1001 CITY AVE EC 911
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City | WYNNEWOOD
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State | PA
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Zip | 19096-3902
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Country | US
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Telephone |
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Fax | 610-645-5414
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Authorized Official
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Title or Position | CONSULTANT
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Name | DONALD MITCHELL
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Credential | PHD
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Telephone | 267-449-9432
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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 |
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License Number State |
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