Provider Demographics
NPI:1407220791
Name:SUMMIT BHC WESTFIELD, LLC
Entity Type:Organization
Organization Name:SUMMIT BHC WESTFIELD, LLC
Other - Org Name:MOUNTAIN LAUREL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-716-4924
Mailing Address - Street 1:355 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16950-1523
Mailing Address - Country:US
Mailing Address - Phone:717-614-3336
Mailing Address - Fax:888-418-7712
Practice Address - Street 1:355 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:PA
Practice Address - Zip Code:16950-1523
Practice Address - Country:US
Practice Address - Phone:717-614-3336
Practice Address - Fax:888-418-7712
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT BEHAVIORAL HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-24
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility