Healthcare Provider Details
I. General information
NPI: 1245601392
Provider Name (Legal Business Name): SALISBURY BEHAVIORAL HEALTH DBA NEW STORY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2015
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2700 COMMERCE DR
HARRISBURG PA
17110-9365
US
IV. Provider business mailing address
211 PERIMETER CENTER PKWY NE STE 750
ATLANTA GA
30346-1318
US
V. Phone/Fax
- Phone: 717-901-9906
- Fax:
- Phone: 770-630-7290
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | BH002849 |
| License Number State | PA |
VIII. Authorized Official
Name:
JENNIFER
D
LOZANO
Title or Position: SVP FINANCIAL SERVICES
Credential:
Phone: 770-630-7290