Healthcare Provider Details

I. General information

NPI: 1003367301
Provider Name (Legal Business Name): FAMILY SERVICE ASSOCIATION OF BUCKS COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1523 MAKEFIELD RD
YARDLEY PA
19067-3181
US

IV. Provider business mailing address

4 CORNERSTONE DR
LANGHORNE PA
19047-1314
US

V. Phone/Fax

Practice location:
  • Phone: 215-428-4237
  • Fax:
Mailing address:
  • Phone: 215-757-6916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number125920
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1007328920050
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: JULIE DEES
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 215-757-6916