Provider Demographics
NPI:1801002308
Name:BALA CHILD AND FAMILY ASSOCIATION
Entity Type:Organization
Organization Name:BALA CHILD AND FAMILY ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-668-1492
Mailing Address - Street 1:29 BALA AVE
Mailing Address - Street 2:SUITE 224
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3209
Mailing Address - Country:US
Mailing Address - Phone:610-668-1492
Mailing Address - Fax:
Practice Address - Street 1:29 BALA AVE
Practice Address - Street 2:SUITE 224
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3209
Practice Address - Country:US
Practice Address - Phone:610-668-1492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty