Healthcare Provider Details

I. General information

NPI: 1265656623
Provider Name (Legal Business Name): LENAPE VALLEY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 W STATE ST
DOYLESTOWN PA
18901-2554
US

IV. Provider business mailing address

500 N WEST ST
DOYLESTOWN PA
18901-2366
US

V. Phone/Fax

Practice location:
  • Phone: 215-345-2273
  • Fax: 215-345-2871
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALAN J HARTL
Title or Position: EXECUTIVE DIRECTOR
Credential: MS
Phone: 267-893-5285