Provider Demographics
NPI:1235293168
Name:HOSANNA MINISTRIES INC
Entity Type:Organization
Organization Name:HOSANNA MINISTRIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DESMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:MAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-221-4188
Mailing Address - Street 1:PO BOX 38152
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-0152
Mailing Address - Country:US
Mailing Address - Phone:215-221-4188
Mailing Address - Fax:
Practice Address - Street 1:1600 W HUNTING PARK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2900
Practice Address - Country:US
Practice Address - Phone:215-221-4188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMFT000266101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAETNAOtherPSYCHOLOGICAL SERVICES
PAHIGHMARKOtherPSYCHOLOGICAL SERVICES
UNITED HEALTHCAREOtherPSYCHOLOGICAL SERVICES
PAPERSONNALCHOICEOtherPSYCHOLOGICAL SERVICES