Provider Demographics
NPI:1922141167
Name:MALVERN INSTITUTE FOR PSYCHIATRIC AND ALCOHOLIC STUDIES, INC.
Entity Type:Organization
Organization Name:MALVERN INSTITUTE FOR PSYCHIATRIC AND ALCOHOLIC STUDIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-941-3348
Mailing Address - Street 1:521 PLYMOUTH RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1638
Mailing Address - Country:US
Mailing Address - Phone:610-941-3390
Mailing Address - Fax:484-342-1010
Practice Address - Street 1:940 W KING RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3166
Practice Address - Country:US
Practice Address - Phone:610-647-0330
Practice Address - Fax:610-647-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital