Healthcare Provider Details

I. General information

NPI: 1407768096
Provider Name (Legal Business Name): PA HEALTHCARE VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1288 VETERANS HWY
LEVITTOWN PA
19056-1616
US

IV. Provider business mailing address

11 MALVERN HILL RD
STERLING MA
01564-2829
US

V. Phone/Fax

Practice location:
  • Phone: 215-810-0061
  • Fax:
Mailing address:
  • Phone: 774-452-3039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL HURLEY
Title or Position: MANAGING PARTNER
Credential:
Phone: 774-452-3039