Provider Demographics
NPI:1609153626
Name:SPIRIT OF GHEEL
Entity Type:Organization
Organization Name:SPIRIT OF GHEEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:610-495-7871
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:KIMBERTON
Mailing Address - State:PA
Mailing Address - Zip Code:19442-0610
Mailing Address - Country:US
Mailing Address - Phone:610-495-7871
Mailing Address - Fax:
Practice Address - Street 1:10 HOLLOW RD
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475
Practice Address - Country:US
Practice Address - Phone:610-495-7871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA144320323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility