Provider Demographics
NPI:1942439385
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 THE CARING PLACE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEE
Authorized Official - Middle Name:P
Authorized Official - Last Name:SECKINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-433-4680
Mailing Address - Street 1:931 HAMILTON ST
Mailing Address - Street 2:FOURTH FLOOR
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-1140
Mailing Address - Country:US
Mailing Address - Phone:610-433-4680
Mailing Address - Fax:610-433-4707
Practice Address - Street 1:931 HAMILTON ST
Practice Address - Street 2:FOURTH FLOOR
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-1140
Practice Address - Country:US
Practice Address - Phone:610-433-4680
Practice Address - Fax:610-433-4707
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-07
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062907L261Q00000X, 261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023235130001Medicaid