Provider Demographics
NPI:1689049843
Name:NEWCOURTLAND SENIOR CENTERS
Entity Type:Organization
Organization Name:NEWCOURTLAND SENIOR CENTERS
Other - Org Name:NEWCOURTLAND CENTER AT ROXBOROUGH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-951-4242
Mailing Address - Street 1:6970 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2114
Mailing Address - Country:US
Mailing Address - Phone:215-951-4290
Mailing Address - Fax:
Practice Address - Street 1:4200B MITCHELL STREET
Practice Address - Street 2:SUIE 1000
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128
Practice Address - Country:US
Practice Address - Phone:215-286-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA315550 - REGULAR261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care