Organization
EDGEWATER PSYCHIATRIC CENTER
Active
Organization
EDGEWATER PSYCHIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN TILSON JR. (DIRECTOR OF BUSINESS OPERATIONS)
(215) 836-3131
Entity
Organization
Contact information
Practice address
295 STATE DR, ELIZABETHVILLE, PA 17023-8661
(215) 836-3131
Mailing address
4391 STURBRIDGE DR, HARRISBURG, PA 17110-3673
(215) 836-3131
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007457920011
—
PA
05
—
1007457920019
—
PA
Enumeration date
04/13/2007
Last updated
08/05/2009
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