Provider Demographics
NPI:1376826552
Name:EXPLORATIONSPHP, INC.
Entity Type:Organization
Organization Name:EXPLORATIONSPHP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WISLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-539-8550
Mailing Address - Street 1:930 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2304
Mailing Address - Country:US
Mailing Address - Phone:610-539-8550
Mailing Address - Fax:
Practice Address - Street 1:930 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-2304
Practice Address - Country:US
Practice Address - Phone:610-539-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA137330261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health