PENN PRESBYTERIAN MEDICAL CTR DETOX REHAB (NPI# 1033259627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033259627 |
| Entity Type | Organization |
| Organization Name | PENN PRESBYTERIAN MEDICAL CTR DETOX REHAB |
| Practice Address |
51 N 39th St Phila PA 19104-2640 |
| Mailing Address |
1500 Market St Um600 Phila PA 19102-2100 |
| Practice Telephone | 2157964640 |
| Practice Fax Number | 6097707792 |
| Mailing Telephone | 2157964640 |
| Mailing Fax Number | 6097707792 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2015-12-16 |
| Authorized Official Name | MR. THOMAS MCCORMICK (ASSISTANT VICE PRESIDENT FINANCE) |
| Authorized Official Telephone | 2157620888 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007297070001 | 05 |
| Street Address |
51 N 39TH ST |
| City | PHILA |
| State | PA |
| Zip Code | 19104-2640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902447980 | Kaitlin James | Nurse Practitioner | 51 N 39th St, Phila, PA 19104-2640 | 2019-10-01 |
| 1598237844 | Mary Cheng | Pharmacist | 51 N 39th St, Phila, PA 19104-2640 | 2018-12-27 |
| 1902378227 | Nishaminy Kasbekar | Pharmacist | 51 N 39th St, Phila, PA 19104-2640 | 2018-12-27 |
| 1902063605 | Penn Presbyterian Medical Center Spu | Clinic/Center | 51 N 39th St, Phila, PA 19104-2640 | 2008-05-20 |
| 1902948813 | Uphs Presbyterian Medical Ctr Dna | Clinic/Center | 51 N 39th St, Phila, PA 19104-2640 | 2007-02-14 |
| 1649310103 | Penn Presbyterian Medical Ctr Iop | Clinic/Center | 51 N 39th St, Phila, PA 19104-2640 | 2007-02-07 |
| 1497804249 | Penn Presbyterian Medical Center | General Acute Care Hospital | 51 N 39th St, Phila, PA 19104-2640 | 2007-01-10 |
| 1134278989 | Penn Presybyterian Medical Center | General Acute Care Hospital | 51 N 39th St, Phila, PA 19104-2640 | 2007-01-10 |
| 1750445110 | Presbyterian Medical Center of The Univ of Pa Health System | Clinic/Center | 51 N 39th St, Phila, PA 19104-2640 | 2006-12-20 |
| 1013944073 | Sonya Lee | Obstetrics & Gynecology | 51 N 39th St, Mob 340, Phila, PA 19104-2640 | 2006-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861016867 | Matthew Alexander Walukonis | Substance Abuse Rehabilitation Facility | 933 S Queen St, York, PA 17403-3935 | 2020-06-04 |
| 1598385924 | Heuer House | Substance Abuse Rehabilitation Facility | 514 Monongahela Ave, Glassport, PA 15045-1425 | 2020-04-27 |
| 1851911523 | Enlightened Solutions Philadelphia,llc | Substance Abuse Rehabilitation Facility | 25 Bala Ave Ste 202, Bala Cynwyd, PA 19004-3215 | 2020-04-22 |
| 1588283832 | Summit Bhc Meadville LLC | Substance Abuse Rehabilitation Facility | 535 Williamson Rd, Meadville, PA 16335-2848 | 2020-04-15 |
| 1538796792 | Genesis House Ministries Inc | Substance Abuse Rehabilitation Facility | 395 E Main St, Uniontown, PA 15401-4347 | 2020-03-26 |
| 1689216574 | Water Gap Capital Partners LLC | Substance Abuse Rehabilitation Facility | 288 Mountain Road, Delaware Water Gap, PA 18327 | 2019-10-11 |
| 1386201713 | Just Believe Recovery Center At Mountains Edge LLC | Substance Abuse Rehabilitation Facility | 306 Sugar Hill Rd, Union Dale, PA 18470-7397 | 2019-05-21 |
| 1689230674 | Snug Harbor Rehabilitation and Recovery LLC | Substance Abuse Rehabilitation Facility | 4638 E Lake Rd, Erie, PA 16511-1410 | 2019-05-15 |
| 1871157115 | Pyramid Healthcare Inc. | Substance Abuse Rehabilitation Facility | 5849 Lincoln Hwy, York, PA 17406-8903 | 2019-04-23 |
| 1962965145 | Providence Living LLC | Substance Abuse Rehabilitation Facility | 1528 Walnut St Ste 1410, Philadelphia, PA 19102-3610 | 2019-04-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.