| Full Name | Ctt/act |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1347 Hausman Rd, Allentown, Pennsylvania |
| Authorized Official Name and Position | Donna K Busch (PAYER CONTRACT SPECIALIST) |
| Authorized Official Contact | 4452063028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ctt/act 111 Elwyn Rd Elwyn PA 19063-4622 Ph: (610) 891-2006 | Ctt/act 1347 Hausman Rd Allentown PA 18104-9063 Ph: (610) 891-2163 |
| NPI Number | 1083878482 |
|---|---|
| Provider Enumeration Date | 07/15/2008 |
| Last Update Date | 02/04/2022 |
| Certification Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083878482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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