Healthcare Provider Details

I. General information

NPI: 1528780277
Provider Name (Legal Business Name): NORTHEASTERN PENNSYLVANIA HUMAN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 WINCHESTER RD
ALLENTOWN PA
18104-2263
US

IV. Provider business mailing address

3500 WINCHESTER RD
ALLENTOWN PA
18104-2263
US

V. Phone/Fax

Practice location:
  • Phone: 484-224-2973
  • Fax: 484-224-2999
Mailing address:
  • Phone: 484-224-2973
  • Fax: 484-224-2999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SUBRINA TAYLOR
Title or Position: CEO
Credential: EDD
Phone: 484-224-2973