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NPI Code Detail

MEDICARE: SOBRIETY THROUGH OUT PATIENT, INC.

MEDICARE: SOBRIETY THROUGH OUT PATIENT, 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 Agency807213PA

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 : 1962543587
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOBRIETY THROUGH OUT PATIENT, INC.
Provider Business Mailing Address
First Line : 2534 N BROAD ST
Second Line : SUITE 200
City : PHILADELPHIA
State : PA
Zip : 19132-4013
Country : US
Telephone Number : 215-227-7867
Fax Number : 215-227-5268
Provider Business Practice Location Address
First Line : 2534 N BROAD ST
Second Line : SUITE 200
City : PHILADELPHIA
State : PA
Zip : 19132-4013
Country : US
Telephone Number : 215-227-7867
Fax Number : 215-227-5268
Authorized Official
Title or Position : CEO
Name : DR. FREDERICK E. HEARD
Credential : PHD
Telephone Number : 215-227-7867
Provider Enumeration Date : 02/08/2007
Last Update Date : 08/22/2020

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Directions to “SOBRIETY THROUGH OUT PATIENT, INC. ” Practice Location

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