Healthcare Provider Details

I. General information

NPI: 1104324292
Provider Name (Legal Business Name): CENTRAL BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 DEKALB ST
NORRISTOWN PA
19401-3415
US

IV. Provider business mailing address

1100 POWELL ST
NORRISTOWN PA
19401-3820
US

V. Phone/Fax

Practice location:
  • Phone: 610-277-4600
  • Fax: 610-275-0216
Mailing address:
  • Phone: 610-277-4600
  • Fax: 610-275-0216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: VALARIE O'CONNOR
Title or Position: PRESIDENT & CEO
Credential: MA
Phone: 484-806-2009