Provider First Line Business Practice Location Address:
80001 STATE RD.
Provider Second Line Business Practice Location Address:
MHM CORRECTIONAL SERVICES, MOD II
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19136-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-624-0797
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/13/2012