| Thirty-nine West Vine | |
|
39 W Vine St Lancaster PA 17603-3946 | |
| (717) 394-5496 | |
| (717) 533-6071 |
| Full Name | Thirty-nine West Vine |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 39 W Vine St, Lancaster, Pennsylvania |
| Authorized Official Name and Position | Harvey Haack (PRESIDENT) |
| Authorized Official Contact | 7173294178 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thirty-nine West Vine 203 Crescent Dr Hershey PA 17033-2335 Ph: (717) 329-4178 | Thirty-nine West Vine 39 W Vine St Lancaster PA 17603-3946 Ph: (717) 394-5496 |
| NPI Number | 1033398078 |
|---|---|
| Provider Enumeration Date | 10/26/2007 |
| Last Update Date | 11/23/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033398078 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 367079 (Pennsylvania) | Primary |
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