NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
1184745572 |   |   |   | PHILADELPHIA MENTAL HEALTH CLINIC | 1235 PINE ST | PHILADELPHIA | PA | 191075945 |
1720302904 | GREEN | CRYSTALIZ |   |   | 1235 PINE ST | PHILADELPHIA | PA | 191075945 |