Provider Demographics
NPI:1487005153
Name:PINEBROOK FAMILY ANSWERS
Entity Type:Organization
Organization Name:PINEBROOK FAMILY ANSWERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TENBROECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-774-1434
Mailing Address - Street 1:402 N FULTON ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-2002
Mailing Address - Country:US
Mailing Address - Phone:610-432-3919
Mailing Address - Fax:
Practice Address - Street 1:16 S BROADWAY STE 2
Practice Address - Street 2:
Practice Address - City:WIND GAP
Practice Address - State:PA
Practice Address - Zip Code:18091-1431
Practice Address - Country:US
Practice Address - Phone:610-863-8151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003866251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health