Organization
SELF LEHIGH VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA FERNANDEZ (FOUNDER/EXECUTIVE DIRECTOR)
(484) 661-3298
Entity
Organization
Contact information
Practice address
40 S 5TH ST, ALLENTOWN, PA 18101-1622
(484) 661-3298
Mailing address
1243 S JEFFERSON ST, ALLENTOWN, PA 18103-3867
(484) 661-3298
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
01/27/2021
Last updated
01/27/2021
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