Healthcare Provider Details

I. General information

NPI: 1497343032
Provider Name (Legal Business Name): LENAPE VALLEY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2021
Last Update Date: 01/08/2021
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 N SHADY RETREAT RD
DOYLESTOWN PA
18901-2514
US

IV. Provider business mailing address

500 N WEST ST
DOYLESTOWN PA
18901-2366
US

V. Phone/Fax

Practice location:
  • Phone: 215-345-5300
  • Fax:
Mailing address:
  • Phone: 267-893-5284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MARY DUBYK
Title or Position: AED SYSTEMS INITIATIVES
Credential:
Phone: 267-893-5284