Provider Demographics
NPI:1851911523
Name:ENLIGHTENED SOLUTIONS PHILADELPHIA ,LLC
Entity Type:Organization
Organization Name:ENLIGHTENED SOLUTIONS PHILADELPHIA ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-270-4006
Mailing Address - Street 1:4 E JIMMIE LEEDS RD STE 3
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4465
Mailing Address - Country:US
Mailing Address - Phone:610-298-1999
Mailing Address - Fax:
Practice Address - Street 1:25 BALA AVE STE 202
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3215
Practice Address - Country:US
Practice Address - Phone:610-298-1999
Practice Address - Fax:267-262-6733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility