Provider Demographics
NPI:1487018180
Name:EBH NORTHEAST SERVICES
Entity Type:Organization
Organization Name:EBH NORTHEAST SERVICES
Other - Org Name:CLARITY WAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAPLESDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CHC, CHPC
Authorized Official - Phone:615-510-3708
Mailing Address - Street 1:PO BOX 670600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-0600
Mailing Address - Country:US
Mailing Address - Phone:615-567-7256
Mailing Address - Fax:
Practice Address - Street 1:544 IRON RIDGE RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-6838
Practice Address - Country:US
Practice Address - Phone:615-567-7256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID SACK MD TN PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009643L207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty