Provider Demographics
NPI:1366689705
Name:SOLIS HEALTHCARE, LP
Entity Type:Organization
Organization Name:SOLIS HEALTHCARE, LP
Other - Org Name:ROXBOROUGH BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:SOUAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-487-4207
Mailing Address - Street 1:5800 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1737
Mailing Address - Country:US
Mailing Address - Phone:215-509-6800
Mailing Address - Fax:215-509-6830
Practice Address - Street 1:5800 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1737
Practice Address - Country:US
Practice Address - Phone:215-509-6800
Practice Address - Fax:215-509-6830
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOLIS HEALTHCARE, LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-07
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA910401282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019096660001Medicaid