Provider Demographics
NPI:1033595921
Name:BECTON COMMUNITY SERVICES
Entity Type:Organization
Organization Name:BECTON COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:BECTON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD LPC
Authorized Official - Phone:267-934-0557
Mailing Address - Street 1:1022 N 46TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-4614
Mailing Address - Country:US
Mailing Address - Phone:267-934-0557
Mailing Address - Fax:
Practice Address - Street 1:5244 LEBANON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2307
Practice Address - Country:US
Practice Address - Phone:267-934-0557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health