Provider Demographics
NPI:1811312283
Name:EQUI-LIBRIUM, INC.
Entity type:Organization
Organization Name:EQUI-LIBRIUM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MS
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BESTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-365-2266
Mailing Address - Street 1:524 FEHR RD
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-9153
Mailing Address - Country:US
Mailing Address - Phone:610-365-2266
Mailing Address - Fax:610-365-2263
Practice Address - Street 1:524 FEHR RD
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-9153
Practice Address - Country:US
Practice Address - Phone:610-365-2266
Practice Address - Fax:610-365-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency