Provider Demographics
NPI:1982468559
Name:IE BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:IE BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORDA
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERPECK
Authorized Official - Suffix:
Authorized Official - Credentials:LBS
Authorized Official - Phone:215-876-5810
Mailing Address - Street 1:1810 COUNTY LINE RD STE 414
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1723
Mailing Address - Country:US
Mailing Address - Phone:215-201-0458
Mailing Address - Fax:
Practice Address - Street 1:1810 COUNTY LINE RD STE 414
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1723
Practice Address - Country:US
Practice Address - Phone:215-201-0458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health