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Main Line Treatment, LLC

Clinic/Center, Rehabilitation, Substance Use Disorder in Paoli, PA. Organization (NPI-2).

NPI number1083172803
StatusActive
Last updated in NPPESMar 16, 2019

Details

NPI
1083172803
Entity type
Organization (NPI-2)
Legal business name
Main Line Treatment, LLC
Organization subpart
No
Enumeration date
Mar 11, 2019
Last updated
Mar 16, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder––Yes

Other names

  • Main Line Treatment, LLC (Doing Business As)

Practice location

1410 Russell Rd Ste 205
Paoli, PA 19301-1200

Phone 610-407-4666 · Fax 610-407-4666

Mailing address

355 Highland Ave
Berwyn, PA 19312-1600

Phone 610-416-9444 · Fax 610-407-4666

Authorized official

Timothy P Boyle
President
6104169444

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