Provider Demographics
NPI:1922386358
Name:THE BEHAVIORAL WELLNESS CENTER AT GIRARD
Entity Type:Organization
Organization Name:THE BEHAVIORAL WELLNESS CENTER AT GIRARD
Other - Org Name:NPHS PSYCHIATRIC HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GERRI
Authorized Official - Middle Name:H
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-787-9001
Mailing Address - Street 1:801 W. GIRARD AVE
Mailing Address - Street 2:ATTN BUSINESS OFFICE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-4212
Mailing Address - Country:US
Mailing Address - Phone:215-787-2000
Mailing Address - Fax:
Practice Address - Street 1:801 W. GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-4212
Practice Address - Country:US
Practice Address - Phone:215-787-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA142360283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007276960064Medicaid
PA39S132Medicare PIN