| Viaquest Behaviaorl Health Of Pa, Llc | |
|
25 Woods Ln Lewistown PA 17044-2082 | |
| (717) 242-2700 | |
| Not Available |
| Full Name | Viaquest Behaviaorl Health Of Pa, Llc |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 25 Woods Ln, Lewistown, Pennsylvania |
| Authorized Official Name and Position | Rich Johnson (OWNER PRESIDENT) |
| Authorized Official Contact | 8006453267 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Viaquest Behaviaorl Health Of Pa, Llc 525 Metro Pl N Suite 450 Dublin OH 43017-5342 Ph: (800) 645-3267 | Viaquest Behaviaorl Health Of Pa, Llc 25 Woods Ln Lewistown PA 17044-2082 Ph: (717) 242-2700 |
| NPI Number | 1336210699 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336210699 | NPI | - | NPPES |
| 0019621050003 | Medicaid | PA | |
| 0019621050001 | Medicaid | PA | |
| 0019621050004 | Medicaid | PA | |
| 0019621050002 | Medicaid | PA | |
| 0428 | Other | PA | BLUE CROSS PROVIDER # |
| 5011962105 | Other | PA | CBHNP PROVIDER # |
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