Colonial Intermediate Unit 20 | |
1650 Kenwood Dr Bethlehem PA 18017-2246 | |
(610) 515-6477 | |
(610) 515-6457 |
Full Name | Colonial Intermediate Unit 20 |
---|---|
Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 1650 Kenwood Dr, Bethlehem, Pennsylvania |
Authorized Official Name and Position | Christopher Wolfel (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6102525550 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Colonial Intermediate Unit 20 6 Danforth Dr Easton PA 18045-7899 Ph: (610) 252-5550 | Colonial Intermediate Unit 20 1650 Kenwood Dr Bethlehem PA 18017-2246 Ph: (610) 515-6477 |
NPI Number | 1396868519 |
---|---|
Provider Enumeration Date | 04/10/2007 |
Last Update Date | 02/09/2021 |
Certification Date | 02/09/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396868519 | NPI | - | NPPES |
100754460 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0855X | Clinic/center - Adolescent And Children Mental Health | 235100 (Pennsylvania) | Primary |
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