Provider Demographics
NPI:1871797167
Name:LEHIGH VALLEY COMMUNITY MENTAL HEALTH CENTER INC
Entity type:Organization
Organization Name:LEHIGH VALLEY COMMUNITY MENTAL HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHLEBOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-221-9135
Mailing Address - Street 1:2030 W TILGHMAN ST
Mailing Address - Street 2:SUITE 105B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4354
Mailing Address - Country:US
Mailing Address - Phone:484-221-9135
Mailing Address - Fax:484-221-9130
Practice Address - Street 1:865 E 4TH ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1935
Practice Address - Country:US
Practice Address - Phone:610-691-4357
Practice Address - Fax:484-221-9130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA242960251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015772780011Medicaid
PA884458Medicare ID - Type Unspecified