Provider Demographics
NPI:1194940502
Name:SUPPORTIVE BEHAVIORAL RESOURCES, INC.
Entity type:Organization
Organization Name:SUPPORTIVE BEHAVIORAL RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCESCO
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TIERI
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:215-333-2280
Mailing Address - Street 1:7901 BUSTLETON AVENUE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3330
Mailing Address - Country:US
Mailing Address - Phone:215-333-2280
Mailing Address - Fax:215-333-2278
Practice Address - Street 1:7901 BUSTLETON AVENUE
Practice Address - Street 2:SUITE 301
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3330
Practice Address - Country:US
Practice Address - Phone:215-333-2280
Practice Address - Fax:215-333-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health