Provider Demographics
NPI:1801807508
Name:URBAN HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:URBAN HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EARLE
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MCNEILL
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:484-461-8780
Mailing Address - Street 1:19 N LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2205
Mailing Address - Country:US
Mailing Address - Phone:484-461-8780
Mailing Address - Fax:484-461-8025
Practice Address - Street 1:19 N LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2205
Practice Address - Country:US
Practice Address - Phone:484-461-8780
Practice Address - Fax:484-461-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-003982-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA137119Medicaid
PA233096208Medicare PIN