Healthcare Provider Details

I. General information

NPI: 1528404134
Provider Name (Legal Business Name): HOLCOMB BEHAVIORAL HEALTH SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E HIGH ST STE 250
POTTSTOWN PA
19464-9226
US

IV. Provider business mailing address

467 CREAMERY WAY
EXTON PA
19341-2508
US

V. Phone/Fax

Practice location:
  • Phone: 610-363-1488
  • Fax: 610-363-8273
Mailing address:
  • Phone: 610-363-1488
  • Fax: 610-363-8273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUMBINI BORA
Title or Position: CRED SPECIALIST
Credential:
Phone: 240-507-9831