MEDICARE: INCOMMUNITY TREATMENT SERVICES

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
1	1041C0700X	Clinical Social Worker

Other Identifiers

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

General Provider Information

NPI Number	:	1548467699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INCOMMUNITY TREATMENT SERVICES

Provider Business Mailing Address
First Line	:	7241 HOLLYWOOD RD
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-1211
Country	:	US
Telephone Number	:	215-641-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	7241 HOLLYWOOD RD
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-1211
Country	:	US
Telephone Number	:	215-641-2311
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT PLOTKIN
Credential	:
Telephone Number	:	215-740-7608

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	08/22/2020

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