Provider Demographics
NPI:1013077551
Name:PMHCC CTT INC
Entity Type:Organization
Organization Name:PMHCC CTT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:CULNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-923-8042
Mailing Address - Street 1:520 N COLUMBUS BLVD
Mailing Address - Street 2:4D
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-4226
Mailing Address - Country:US
Mailing Address - Phone:215-923-8042
Mailing Address - Fax:215-923-8064
Practice Address - Street 1:520 N COLUMBUS BLVD
Practice Address - Street 2:4D
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-4226
Practice Address - Country:US
Practice Address - Phone:215-923-8042
Practice Address - Fax:215-923-8064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-06-17
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2008-06-17
Provider Licenses
StateLicense IDTaxonomies
PA251203882251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management