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General NPI Number Information
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NPI Number | 1942447891
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Entity Type | Organization
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Legal Business Name | MADDOX BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 01/14/2009
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Provider Practice Location Address
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Address Line | 7045 SHERWOOD RD
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City | PHILADELPHIA
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State | PA
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Zip | 19151-2326
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Country | US
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Telephone | 267-978-7939
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Fax | 215-477-3769
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Provider Business Mailing Address
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Address Line | 7045 SHERWOOD RD
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City | PHILADELPHIA
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State | PA
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Zip | 19151-2326
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Country | US
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Telephone | 267-978-7939
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Fax | 215-477-3769
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MS. HILLERIE B. MADDOX
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Credential | M.S.
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Telephone | 267-978-7939
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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 |
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License Number State | PA
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