1538127535 NPI number — SALISBURY BEHAVIORAL HEALTH, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538127535 NPI number — SALISBURY BEHAVIORAL HEALTH, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SALISBURY BEHAVIORAL HEALTH, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538127535
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1819 PEACHTREE RD NE
Provider Second Line Business Mailing Address:
STE 450
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30309-1853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-968-2663
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
614 N EASTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENSIDE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19038-4301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-884-5566
Provider Business Practice Location Address Fax Number:
215-885-3165
Provider Enumeration Date:
05/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LOZANO
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
VP FINANCIAL SERVICES
Authorized Official Telephone Number:
770-630-7290

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100004639 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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