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NPI Code Detail

MEDICARE: MERAKEY PENNSYLVANIA

MEDICARE: MERAKEY PENNSYLVANIA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1023382033
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERAKEY PENNSYLVANIA
Provider Business Mailing Address
First Line : 4251 CRUMS MILL RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17112-2824
Country : US
Telephone Number : 215-836-3131
Fax Number : 215-273-5975
Provider Business Practice Location Address
First Line : 4606 LEE ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71302-3235
Country : US
Telephone Number : 215-836-3131
Fax Number :
Authorized Official
Title or Position : CORP SR DIRECCTOR OF BUS OPS
Name : MR. NORMAN TILSON JR.
Credential :
Telephone Number : 215-836-3131
Provider Enumeration Date : 03/08/2012
Last Update Date : 08/01/2024

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Directions to “MERAKEY PENNSYLVANIA ” Practice Location

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