Provider Demographics
NPI:1326418245
Name:NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY
Entity Type:Organization
Organization Name:NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY
Other - Org Name:NHCLV-BETHLEHEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MIRANDA
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:610-820-7605
Mailing Address - Street 1:635 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6332
Mailing Address - Country:US
Mailing Address - Phone:610-820-7605
Mailing Address - Fax:610-820-7606
Practice Address - Street 1:1210 E 4TH ST
Practice Address - Street 2:FOWLER FAMILY CENTER
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-2016
Practice Address - Country:US
Practice Address - Phone:610-849-9157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-05
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015738261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA391039OtherMEDICARE CERTIFICATION NUMBER PART A