Provider Demographics
NPI:1851535322
Name:WANNA PLAY, INC.
Entity Type:Organization
Organization Name:WANNA PLAY, INC.
Other - Org Name:THE WANNA PLAY PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:610-853-2898
Mailing Address - Street 1:3625 CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3602
Mailing Address - Country:US
Mailing Address - Phone:610-853-2898
Mailing Address - Fax:610-853-0837
Practice Address - Street 1:3625 CHAPEL RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3602
Practice Address - Country:US
Practice Address - Phone:610-853-2898
Practice Address - Fax:610-853-0837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty