717 Health LLC
Organization Active NPI Adult Mental Health Clinic/Center · Lancaster, PA
NPI 1891559522 · NPPES record last updated Mar 18, 2024
Key facts
- NPI
- 1891559522
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Mental Health Clinic/Center 261QM0850X
- Legal business name
- 717 HEALTH LLC
- Practice address
- 1604 Lititz Pike
Lancaster, PA 17601-6534 - Phone
- (717) 818-5462
- NPI assigned
- Feb 13, 2024
- Organization subpart
- No
Authorized official
- Name
- Jessica Brunner
- Title
- Executive Director
- Phone
- (717) 818-5462
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D2308758 | 717 Health LLC | Certificate of waiver | Aug 1, 2026 |
National Provider Directory
Locations
1604 Lititz Pike
Lancaster, PA 17601
Phone (717) 818-5462
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | Yes | ||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X |
Addresses
Primary practice location
1604 Lititz Pike
Lancaster, PA 17601-6534
Mailing address
1604 Lititz Pike
Lancaster, PA 17601-6534
Phone (717) 818-5462
Other names
- Northeast Wellness Collective
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.