57hundred Group
Community/Behavioral Health in Philadelphia, PA. Organization (NPI-2).
NPI number1720675770
StatusActive
Last updated in NPPESDec 23, 2020
Details
- NPI
- 1720675770
- Entity type
- Organization (NPI-2)
- Legal business name
- 57hundred Group
- Organization subpart
- No
- Enumeration date
- Dec 23, 2020
- Certification date
- Dec 23, 2020
- Last updated
- Dec 23, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
3217 W Norris StPhiladelphia, PA 19121-1716
Phone 817-484-8628
Mailing address
2 Bala Plz Ste 300Bala Cynwyd, PA 19004-1512
Phone 267-879-1616
Authorized official
Ila Smith
Ceo
8174848628
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