Healthcare Provider Details
I. General information
NPI: 1619379211
Provider Name (Legal Business Name): ADVANCED BEHAVIORAL HEALTH TREATMENT CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2014
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
542 N LEWIS RD
LIMERICK PA
19468-3521
US
IV. Provider business mailing address
542 N LEWIS RD
LIMERICK PA
19468-3521
US
V. Phone/Fax
- Phone: 610-275-0345
- Fax: 610-275-0346
- Phone: 610-275-0345
- Fax: 610-275-0346
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
MUHAMMAD
NADEEM
SHAMSI
Title or Position: PRESIDENT
Credential: MD
Phone: 610-275-0345