Healthcare Provider Details

I. General information

NPI: 1194738385
Provider Name (Legal Business Name): NHS EDGEWATER PSYCHIATRIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 GERMANTOWN PIKE
LAFAYETTE HILL PA
19444-1801
US

IV. Provider business mailing address

620 GERMANTOWN PIKE
LAFAYETTE HILL PA
19444-1801
US

V. Phone/Fax

Practice location:
  • Phone: 610-260-4600
  • Fax: 610-260-4699
Mailing address:
  • Phone: 610-260-4600
  • Fax: 610-260-4699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA D WYNNE
Title or Position: NHS PRIVACY OFFICER
Credential: ESQUIRE
Phone: 610-260-4618