Provider Demographics
NPI:1760014146
Name:FIREBIRD MANAGEMENT
Entity type:Organization
Organization Name:FIREBIRD MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOSSOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:610-212-0738
Mailing Address - Street 1:120 E UWCHLAN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1275
Mailing Address - Country:US
Mailing Address - Phone:610-524-8701
Mailing Address - Fax:610-524-8705
Practice Address - Street 1:120 E UWCHLAN AVE STE 202
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1275
Practice Address - Country:US
Practice Address - Phone:610-524-8701
Practice Address - Fax:610-524-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty