Provider Demographics
NPI:1386498921
Name:CHANNEL BEHAVIORAL CARE PA LLC
Entity type:Organization
Organization Name:CHANNEL BEHAVIORAL CARE PA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SIMCHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RBT
Authorized Official - Phone:646-238-4930
Mailing Address - Street 1:50 W EDMONSTON DR STE 402
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1245
Mailing Address - Country:US
Mailing Address - Phone:646-238-4930
Mailing Address - Fax:
Practice Address - Street 1:1009 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552-9666
Practice Address - Country:US
Practice Address - Phone:646-238-4930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health