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General NPI Number Information
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NPI Number | 1942359120
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Entity Type | Organization
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Legal Business Name | CENTRALIZED COMPREHENSIVE HUMAN SERVICES, INC.
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 10/15/2013
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Provider Practice Location Address
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Address Line | 112 N BROAD ST RM 821
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1510
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Country | US
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Telephone | 215-568-0622
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Fax | 215-568-0769
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Provider Business Mailing Address
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Address Line | 112 N BROAD ST RM 821
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1510
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Country | US
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Telephone | 215-568-0622
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Fax | 215-568-0769
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Authorized Official
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Title or Position | VICE PRESIDENT - FINANCE
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Name | ALICE G YOUNG
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Credential | M.B.A. FINANCE
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Telephone | 215-568-0622
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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 | 122000
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License Number State | PA
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