Organization
PHILHAVEN RESIDENTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP D HESS (CEO)
(800) 932-0359
Entity
Organization
Contact information
Practice address
643 HORSESHOE PK, LEBANON, PA 17064
(800) 932-0359
Mailing address
283 S BUTLER RD, MT GRETNA, PA 17064
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007720000061
—
PA
Enumeration date
04/11/2007
Last updated
07/27/2018
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