Provider Demographics
NPI:1841429529
Name:NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY
Entity Type:Organization
Organization Name:NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY
Other - Org Name:VIDA NUEVA AT CASA GUADALUPE
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:P
Authorized Official - Last Name:HADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-820-7605
Mailing Address - Street 1:635 E BROAD ST FL 4
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6332
Mailing Address - Country:US
Mailing Address - Phone:610-820-7605
Mailing Address - Fax:610-433-4707
Practice Address - Street 1:218 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3508
Practice Address - Country:US
Practice Address - Phone:610-841-8400
Practice Address - Fax:610-841-8401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-02
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062907L261Q00000X
261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023235130002Medicaid