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General NPI Number Information
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NPI Number | 1821885815
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Entity Type | Organization
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Legal Business Name | REVOLUTIONARY MENTAL HEALTH INC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 1650 MARKET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19103-7301
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Country | US
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Telephone | 240-797-6869
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Fax |
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Provider Business Mailing Address
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Address Line | 1395 OAK LN
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City | QUAKERTOWN
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State | PA
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Zip | 18951-3004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ROBIN CARDAN
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Credential | MD
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Telephone | 240-797-6869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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