Organization
PHILHAVEN
Active
Other names
WellSpan Philhaven, WellSpan Philhaven Crisis Intervention
Organization subpart
No
Provider details
NPI number
Authorized official
MANTHA KOTSALOS (VP & PRESIDENT PHILHAVEN)
(717) 270-2423
Entity
Organization
Contact information
Practice address
209 HATHAWAY PARK, LEBANON, PA 17042-6163
(717) 274-3363
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007720000124
—
PA
05
—
1007720000151
—
PA
05
—
1007720000170
—
PA
Enumeration date
04/16/2007
Last updated
03/10/2025
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