Provider Demographics
NPI:1427183904
Name:PHILADELPHIA HEALTH & EDUCATION CORP.
Entity Type:Organization
Organization Name:PHILADELPHIA HEALTH & EDUCATION CORP.
Other - Org Name:MCPHU D & A CENTER CITY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERBERT-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:215-831-4811
Mailing Address - Street 1:1427 VINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1031
Mailing Address - Country:US
Mailing Address - Phone:215-831-4811
Mailing Address - Fax:215-831-2603
Practice Address - Street 1:1427 VINE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1031
Practice Address - Country:US
Practice Address - Phone:215-831-4811
Practice Address - Fax:215-831-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007571110309Medicaid