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General NPI Number Information
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NPI Number | 1326450180
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Entity Type | Organization
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Legal Business Name | JUMP START OF THE LEHIGH VALLEY, LLC
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 930 SPRINGHOUSE RD
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City | ALLENTOWN
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State | PA
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Zip | 18104-3363
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Country | US
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Telephone | 610-390-5014
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Fax | 610-398-7134
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Provider Business Mailing Address
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Address Line | 930 SPRINGHOUSE RD
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City | ALLENTOWN
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State | PA
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Zip | 18104-3363
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Country | US
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Telephone | 610-390-5014
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Fax | 610-398-7134
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Authorized Official
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Title or Position | PRESIDENT/SPECIAL INSTRUCTOR
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Name | MRS. SUSAN LYNN SMITH
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Credential |
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Telephone | 610-390-5014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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