Provider Demographics
NPI:1588727903
Name:ALLENTOWN RESCUE MISSION
Entity type:Organization
Organization Name:ALLENTOWN RESCUE MISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:610-740-5500
Mailing Address - Street 1:355 W HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-1819
Mailing Address - Country:US
Mailing Address - Phone:610-740-5500
Mailing Address - Fax:610-740-0646
Practice Address - Street 1:355 W HAMILTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-1819
Practice Address - Country:US
Practice Address - Phone:610-740-5500
Practice Address - Fax:610-740-0646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA397041324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility