Healthcare Provider Details

I. General information

NPI: 1538127535
Provider Name (Legal Business Name): SALISBURY BEHAVIORAL HEALTH, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 N EASTON RD
GLENSIDE PA
19038-4301
US

IV. Provider business mailing address

211 PERIMETER CENTER PKWY NE STE 750
ATLANTA GA
30346-1318
US

V. Phone/Fax

Practice location:
  • Phone: 215-884-5566
  • Fax: 215-885-3165
Mailing address:
  • Phone: 770-630-7290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LOZANO
Title or Position: SVP FINANCIAL SERVICES
Credential:
Phone: 770-630-7290