Provider Demographics
NPI:1669866976
Name:CAMPHILL SOLTANE
Entity Type:Organization
Organization Name:CAMPHILL SOLTANE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DAY SUPPORTS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-469-0933
Mailing Address - Street 1:224 NANTMEAL RD
Mailing Address - Street 2:
Mailing Address - City:GLENMOORE
Mailing Address - State:PA
Mailing Address - Zip Code:19343-2637
Mailing Address - Country:US
Mailing Address - Phone:610-469-0933
Mailing Address - Fax:610-469-1054
Practice Address - Street 1:224 NANTMEAL RD
Practice Address - Street 2:
Practice Address - City:GLENMOORE
Practice Address - State:PA
Practice Address - Zip Code:19343-2637
Practice Address - Country:US
Practice Address - Phone:610-469-0933
Practice Address - Fax:610-469-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102155365OtherMEDICAL ASSISTANCE