Provider Demographics
NPI:1982010039
Name:PHILADELPHIA NEW LEAF LLC
Entity Type:Organization
Organization Name:PHILADELPHIA NEW LEAF LLC
Other - Org Name:ADVANCED HEALTH AND EDUCATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:SILLETTI
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:908-400-8606
Mailing Address - Street 1:3600 MARKET ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2641
Mailing Address - Country:US
Mailing Address - Phone:908-400-8606
Mailing Address - Fax:908-928-9353
Practice Address - Street 1:3600 MARKET ST
Practice Address - Street 2:SUITE 601
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2641
Practice Address - Country:US
Practice Address - Phone:908-400-8606
Practice Address - Fax:908-928-9353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder