Provider Demographics
NPI:1023724903
Name:PENN FOUNDATION INC
Entity type:Organization
Organization Name:PENN FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:REASER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-404-5861
Mailing Address - Street 1:807 LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1549
Mailing Address - Country:US
Mailing Address - Phone:215-257-6551
Mailing Address - Fax:833-506-2774
Practice Address - Street 1:1200 NEW RODGERS RD STE C-14
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-2525
Practice Address - Country:US
Practice Address - Phone:215-257-6551
Practice Address - Fax:833-506-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health