Provider Demographics
NPI:1548547417
Name:WES HEATH CENTER
Entity type:Organization
Organization Name:WES HEATH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MOBILE ASSESSMENT TECHNICIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMALLS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:215-455-2626
Mailing Address - Street 1:1315 WINDRIM AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-2710
Mailing Address - Country:US
Mailing Address - Phone:215-226-2626
Mailing Address - Fax:215-754-0213
Practice Address - Street 1:1315 WINDRIM AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-2710
Practice Address - Country:US
Practice Address - Phone:215-226-2626
Practice Address - Fax:215-754-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health