Basic Information
| Provider Information | |||||||||
| NPI: | 1275961518 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY HOSPITAL DRUG AND ALCOHOL RECOVERY CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2600 W 9TH ST | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190132040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104977200 | ||||||||
| FaxNumber: | 6104977244 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 W 9TH ST | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190132040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104977200 | ||||||||
| FaxNumber: | 6104977244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2013 | ||||||||
| LastUpdateDate: | 10/24/2013 | ||||||||
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| AuthorizedOfficialLastName: | DURGUN | ||||||||
| AuthorizedOfficialFirstName: | CATHIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 6104977249 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.