Provider Demographics
NPI:1588603872
Name:BHC NORTHWEST PSYCHIATRIC HOSPITAL LLC
Entity Type:Organization
Organization Name:BHC NORTHWEST PSYCHIATRIC HOSPITAL LLC
Other - Org Name:BROOKE GLEN BEHAVIORAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SRVP CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:7170 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2301
Mailing Address - Country:US
Mailing Address - Phone:215-641-5300
Mailing Address - Fax:215-641-6815
Practice Address - Street 1:7170 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2301
Practice Address - Country:US
Practice Address - Phone:215-641-5300
Practice Address - Fax:215-641-6815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA122130283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019651800002Medicaid
PA0019651800002Medicaid