Provider Demographics
NPI:1588013882
Name:CHILDRENS BEHAVIORAL HEALTH CENTER
Entity Type:Organization
Organization Name:CHILDRENS BEHAVIORAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:KOSSOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:610-212-0738
Mailing Address - Street 1:848 W KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1714
Mailing Address - Country:US
Mailing Address - Phone:610-212-0738
Mailing Address - Fax:610-383-9494
Practice Address - Street 1:848 W KINGS HWY
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1714
Practice Address - Country:US
Practice Address - Phone:610-212-0738
Practice Address - Fax:610-383-9494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003680L251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health