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512 Bank Street Bowmanstown PA 18030 | |
| (484) 526-2400 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 512 Bank Street, Bowmanstown, Pennsylvania |
| Authorized Official Name and Position | Sue Chiavaroli (CVO SUPERVISOR) |
| Authorized Official Contact | 4845263569 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
801 Ostrum St Bethlehem PA 18015-1000 Ph: (484) 526-4000 | 512 Bank Street Bowmanstown PA 18030 Ph: (484) 526-2400 |
| NPI Number | 1184274946 |
|---|---|
| Provider Enumeration Date | 09/13/2019 |
| Last Update Date | 04/14/2021 |
| Certification Date | 04/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184274946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |