Provider Demographics
NPI:1740644426
Name:BIRCHWOOD BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:BIRCHWOOD BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANI
Authorized Official - Middle Name:M
Authorized Official - Last Name:GORKOS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:484-860-0492
Mailing Address - Street 1:1541 ALTA DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-5632
Mailing Address - Country:US
Mailing Address - Phone:484-860-0492
Mailing Address - Fax:
Practice Address - Street 1:1541 ALTA DR
Practice Address - Street 2:SUITE 301
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-5632
Practice Address - Country:US
Practice Address - Phone:484-860-0492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health