Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 111 Elwyn Rd, Elwyn, Pennsylvania |
Authorized Official Name and Position | Donna K Busch (PAYER CONTRACT SPECIALIST) |
Authorized Official Contact | 6106396932 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
111 Elwyn Rd Elwyn PA 19063-4622 Ph: (610) 891-2000 | 111 Elwyn Rd Elwyn PA 19063-4622 Ph: (610) 891-2000 |
NPI Number | 1962557314 |
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Provider Enumeration Date | 01/24/2007 |
Last Update Date | 11/11/2021 |
Certification Date | 11/11/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962557314 | NPI | - | NPPES |
1000021240490 | Medicaid | PA | |
1000021240491 | Medicaid | PA | |
1000021240494 | Medicaid | PA |