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General NPI Number Information
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NPI Number | 1972780310
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Entity Type | Organization
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Legal Business Name | COMMUNITY ADVOCATES ASSOCIATION FOR CHILDREN AND YOUTH, INC
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 42 S 15TH ST SUITE 1313
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2218
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Country | US
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Telephone | 215-988-0250
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Fax | 215-988-0280
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Provider Business Mailing Address
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Address Line | 2313 W OXFORD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19121-2915
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Country | US
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Telephone | 215-769-8480
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Fax | 215-765-8493
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. GARY LEROY HALL
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Credential | M.ED
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Telephone | 215-769-8480
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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 |
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