Provider Demographics
NPI:1881939155
Name:PHILA BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:PHILA BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VONCEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARRIGAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:215-669-6325
Mailing Address - Street 1:1501 W CAYUGA ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-1905
Mailing Address - Country:US
Mailing Address - Phone:215-669-6325
Mailing Address - Fax:
Practice Address - Street 1:1501 W CAYUGA ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19140-1905
Practice Address - Country:US
Practice Address - Phone:215-669-6325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management