MEDICARE: STOP AND 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	807356	PA

General Provider Information

NPI Number	:	1790812691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STOP AND SURRENDER INC

Provider Business Mailing Address
First Line	:	2400 W LEHIGH AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-3236
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	:	EXECUTIVE DIRECTOR
Name	:	MR. ERWIN WARFIELD
Credential	:
Telephone Number	:	215-225-4626

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	08/22/2020

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Directions to “STOP AND SURRENDER INC ” Practice Location

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