| Clarvida | |
|
777 Blakeslee Boulevard Drive East Lehighton PA 18235-1464 | |
| (610) 377-8525 | |
| (610) 377-8548 |
| Full Name | Clarvida |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 777 Blakeslee Boulevard Drive East, Lehighton, Pennsylvania |
| Authorized Official Name and Position | Tim Sohosky (COO) |
| Authorized Official Contact | 5706285215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarvida 777 Blakeslee Boulevard Drive East Lehighton PA 18235-1464 Ph: (610) 377-8525 | Clarvida 777 Blakeslee Boulevard Drive East Lehighton PA 18235-1464 Ph: (610) 377-8525 |
| NPI Number | 1174694897 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 07/12/2024 |
| Certification Date | 07/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174694897 | NPI | - | NPPES |
| 1000017170558 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 206880 (Pennsylvania) | Primary |
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