Healthcare Provider Details

I. General information

NPI: 1689676249
Provider Name (Legal Business Name): LEHIGH VALLEY HOSPITAL MUHLENBERG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 W JONATHAN ST SUITE 200
ALLENTOWN PA
18104-3170
US

IV. Provider business mailing address

1728 W JONATHAN ST SUITE 200
ALLENTOWN PA
18104-3170
US

V. Phone/Fax

Practice location:
  • Phone: 610-433-8550
  • Fax: 610-433-4488
Mailing address:
  • Phone: 610-433-8550
  • Fax: 610-433-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. OLIVER D NEITH JR.
Title or Position: PROGRAM DIRECTOR
Credential: LSW
Phone: 610-433-8550