Provider Demographics
NPI:1730351693
Name:HOLCOMB BEHAVIORAL HEALTH SYSTEMS
Entity type:Organization
Organization Name:HOLCOMB BEHAVIORAL HEALTH SYSTEMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DIFABIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-363-1488
Mailing Address - Street 1:467 CREAMERY WAY
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2508
Mailing Address - Country:US
Mailing Address - Phone:610-363-1488
Mailing Address - Fax:610-363-8273
Practice Address - Street 1:1013 HADDON AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-2010
Practice Address - Country:US
Practice Address - Phone:856-858-2616
Practice Address - Fax:856-858-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40317-01-48251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health