Provider Demographics
NPI:1356022834
Name:A & T 215 HOLDINGS LLC
Entity type:Organization
Organization Name:A & T 215 HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ATIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROOMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-977-0121
Mailing Address - Street 1:1242 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-4338
Mailing Address - Country:US
Mailing Address - Phone:267-977-0121
Mailing Address - Fax:
Practice Address - Street 1:1242 S 20TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-4338
Practice Address - Country:US
Practice Address - Phone:267-977-0121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No177F00000XOther Service ProvidersLodging
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit