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NPI Code Detail

MEDICARE: COMMUNITY COUNCIL

MEDICARE: COMMUNITY COUNCIL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency123850PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093848426
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY COUNCIL
Provider Business Mailing Address
First Line : 4900 WYALUSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-5127
Country : US
Telephone Number : 215-473-7033
Fax Number : 215-933-6926
Provider Business Practice Location Address
First Line : 4900 WYALUSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-5127
Country : US
Telephone Number : 215-473-7033
Fax Number : 215-933-6926
Authorized Official
Title or Position : CHIEF INFORMATIONS OFFICER
Name : MR. JAMES PAIGE
Credential :
Telephone Number : 215-473-7033
Provider Enumeration Date : 03/14/2007
Last Update Date : 04/23/2008

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Directions to “COMMUNITY COUNCIL ” Practice Location

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