Healthcare Provider Details

I. General information

NPI: 1760955959
Provider Name (Legal Business Name): LENAPE VALLEY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 BATH RD
BRISTOL PA
19007
US

IV. Provider business mailing address

500 N WEST ST
DOYLESTOWN PA
18901-2366
US

V. Phone/Fax

Practice location:
  • Phone: 215-785-9765
  • Fax:
Mailing address:
  • Phone: 215-345-5300
  • Fax: 267-893-5300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY DUBYK
Title or Position: ASSOCIATE EXECUTIVE DIRECTOR
Credential:
Phone: 267-893-5284