| Wellspan Philhaven | |
|
283 S Butler Rd Lebanon PA 17042-8939 | |
| (717) 270-2425 | |
| Not Available |
| Full Name | Wellspan Philhaven |
|---|---|
| Speciality | Clinic/center |
| Location | 283 S Butler Rd, Lebanon, Pennsylvania |
| Authorized Official Name and Position | Mantha Kotsalos (VP & PRESIDENT PHILHAVEN) |
| Authorized Official Contact | 7172702423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspan Philhaven 601 Memory Ln York PA 17402-2231 Ph: (717) 851-1405 | Wellspan Philhaven 283 S Butler Rd Lebanon PA 17042-8939 Ph: (717) 270-2425 |
| NPI Number | 1508081639 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 06/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508081639 | NPI | - | NPPES |
| 1007720000120 | Medicaid | PA | |
| 1007720000147 | Medicaid | PA | |
| 1007720000148 | Medicaid | PA | |
| 1007720000150 | Medicaid | PA | |
| 1007720000123 | Medicaid | PA | |
| 1007720000144 | Medicaid | PA | |
| 1007720000149 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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