Provider Demographics
NPI:1336680941
Name:AMERICAN CARE NETWORK CLINIC
Entity Type:Organization
Organization Name:AMERICAN CARE NETWORK CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMIRA
Authorized Official - Middle Name:SEHAM
Authorized Official - Last Name:YASIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-201-4019
Mailing Address - Street 1:530 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-2802
Mailing Address - Country:US
Mailing Address - Phone:610-200-5121
Mailing Address - Fax:267-712-2729
Practice Address - Street 1:530 N 7TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-2802
Practice Address - Country:US
Practice Address - Phone:267-554-7097
Practice Address - Fax:267-812-5414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033691320001Medicaid
PA1033691320003Medicaid