Full Name | |
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Speciality | Community/behavioral Health |
Location | 111 Elwyn Rd, Elwyn, Pennsylvania |
Authorized Official Name and Position | Donna Busch (PAYER CONTRACT SPECIALIST) |
Authorized Official Contact | 4452063028 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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111 Elwyn Rd Elwyn PA 19063-4622 Ph: (610) 891-2000 | 111 Elwyn Rd Elwyn PA 19063-4622 Ph: (610) 891-2000 |
NPI Number | 1639371792 |
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Provider Enumeration Date | 06/01/2007 |
Last Update Date | 02/16/2022 |
Certification Date | 02/16/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639371792 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |