Provider Demographics
NPI:1578062493
Name:BELMONT BEHAVIORAL HOSPITAL, LLC
Entity Type:Organization
Organization Name:BELMONT BEHAVIORAL HOSPITAL, LLC
Other - Org Name:PHILADELPHIA CHILDREN'S CRISIS RESPONSE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VP & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-861-6000
Mailing Address - Street 1:6100 TOWER CIR STE 1000
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1509
Mailing Address - Country:US
Mailing Address - Phone:615-861-6000
Mailing Address - Fax:
Practice Address - Street 1:3300 HENRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129
Practice Address - Country:US
Practice Address - Phone:215-515-9433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELMONT BEHAVIORAL HOSPITAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-06
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health