| |
283 S Butler Rd Lebanon PA 17042-8939 | |
(717) 270-2425 | |
Not Available |
Full Name | |
---|---|
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 |
---|---|
601 Memory Ln York PA 17402-2231 Ph: (717) 851-1405 | 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 |
Agape Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Cumberland St, Lebanon, PA 17042 Phone: 717-270-0335 Fax: 717-270-9740 | |
Lebanon Family Health Service Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 Cumberland St, Lebanon, PA 17042 Phone: 717-273-6741 Fax: 717-273-6337 |