Provider Demographics
NPI:1265795322
Name:FINAL MILE BEHAVIORAL MANAGEMENT SYSTEMS LLC
Entity type:Organization
Organization Name:FINAL MILE BEHAVIORAL MANAGEMENT SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:QASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-778-7261
Mailing Address - Street 1:5070 PARKSIDE AVE
Mailing Address - Street 2:STE 2103
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-4747
Mailing Address - Country:US
Mailing Address - Phone:215-778-7261
Mailing Address - Fax:267-200-0333
Practice Address - Street 1:2050 S 58TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-5932
Practice Address - Country:US
Practice Address - Phone:215-724-2218
Practice Address - Fax:215-724-6924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty