Healthcare Provider Details
I. General information
NPI: 1992919476
Provider Name (Legal Business Name): BEHAVIORAL HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2007
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
822 MARIETTA AVE
LANCASTER PA
17603-3239
US
IV. Provider business mailing address
822 MARIETTA AVE
LANCASTER PA
17603-3239
US
V. Phone/Fax
- Phone: 717-399-8288
- Fax: 717-399-8968
- Phone: 717-399-8288
- Fax: 717-399-8968
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | 323720 |
| License Number State | PA |
VIII. Authorized Official
Name: MR.
ERIC
H
ESHLEMAN
Title or Position: CEO
Credential: M.ED
Phone: 717-399-8288