Provider Demographics
NPI:1265473722
Name:YAPA GROUP THERAPY, INC.
Entity type:Organization
Organization Name:YAPA GROUP THERAPY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWAIDELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-997-9959
Mailing Address - Street 1:1 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2226
Mailing Address - Country:US
Mailing Address - Phone:215-997-9959
Mailing Address - Fax:
Practice Address - Street 1:1 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2252
Practice Address - Country:US
Practice Address - Phone:215-997-9959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA610334Medicare PIN