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General NPI Number Information
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NPI Number | 1992079909
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Entity Type | Organization
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Legal Business Name | MERAKEY PENNSYLVANIA
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 3303 TULANE AVE # 3
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City | NEW ORLEANS
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State | LA
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Zip | 70119-7185
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Country | US
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Telephone | 215-836-3131
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Fax | 215-273-5975
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Provider Business Mailing Address
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Address Line | 4391 STURBRIDGE DR
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City | HARRISBURG
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State | PA
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Zip | 17110-3673
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Country | US
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Telephone | 215-836-3131
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Fax | 215-273-5975
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Authorized Official
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Title or Position | CORP SR. DIRECTOR OF BUSINESS OPS
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Name | MR. NORMAN E TILSON JR.
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Credential |
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Telephone | 215-836-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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