Organization
PENNSYLVANIA INTEGRATIVE CLINICAL SERVICES, INC.
Active
Other names
Lehigh Valley Integrative Clinical Services
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNATHAN JONES (CHIEF EXECUTIVE OFFICER)
(610) 438-5827
Entity
Organization
Contact information
Practice address
41 COMMUNITY DR, EASTON, PA 18045-2668
(610) 438-5827
Mailing address
41 COMMUNITY DR, EASTON, PA 18045-2668
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QG0250X
Genetics Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1039062240001
—
PA
Enumeration date
04/30/2021
Last updated
12/18/2023
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