Provider Demographics
NPI:1508284894
Name:PENNSYLVANIA SUPPORT COORDINATION, INC
Entity Type:Organization
Organization Name:PENNSYLVANIA SUPPORT COORDINATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMERKHANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-488-5583
Mailing Address - Street 1:2201 STRAHLE ST APT C1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2500
Mailing Address - Country:US
Mailing Address - Phone:888-488-5583
Mailing Address - Fax:215-305-8215
Practice Address - Street 1:2201 STRAHLE ST APT C1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-2500
Practice Address - Country:US
Practice Address - Phone:888-488-5583
Practice Address - Fax:215-305-8215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management