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NPI Code Detail

MEDICARE: SUPPORTIVE BEHAVIORAL RESOURCES, INC.

MEDICARE: SUPPORTIVE BEHAVIORAL RESOURCES, INC.
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 Agency

General Provider Information

NPI Number : 1194940502
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUPPORTIVE BEHAVIORAL RESOURCES, INC.
Provider Business Mailing Address
First Line : 7901 BUSTLETON AVENUE
Second Line : SUITE 301
City : PHILADELPHIA
State : PA
Zip : 19152-3330
Country : US
Telephone Number : 215-333-2280
Fax Number : 215-333-2278
Provider Business Practice Location Address
First Line : 7901 BUSTLETON AVENUE
Second Line : SUITE 301
City : PHILADELPHIA
State : PA
Zip : 19152-3330
Country : US
Telephone Number : 215-333-2280
Fax Number : 215-333-2278
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. FRANCESCO JOSEPH TIERI
Credential : M.ED.
Telephone Number : 215-333-2280
Provider Enumeration Date : 04/13/2007
Last Update Date : 08/22/2020

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Directions to “SUPPORTIVE BEHAVIORAL RESOURCES, INC. ” Practice Location

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