MEDICARE: STOP & SURRENDER, 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
1	251S00000X	Community/Behavioral Health Agency	807356	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0017300850003	OTHER	PA	PROVIDER ID

General Provider Information

NPI Number	:	1548550361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STOP & SURRENDER, INC

Provider Business Mailing Address
First Line	:	2522 W HUNTINGDON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-3633
Country	:	US
Telephone Number	:	215-225-4626
Fax Number	:	215-225-4634

Provider Business Practice Location Address
First Line	:	2522 W HUNTINGDON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-3633
Country	:	US
Telephone Number	:	215-225-4626
Fax Number	:	215-225-4634

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. LATOYA WARFIELD
Credential	:
Telephone Number	:	215-225-4626

Provider Enumeration Date	:	04/13/2011
Last Update Date	:	04/13/2011

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Directions to “STOP & SURRENDER, INC ” Practice Location

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