39D2117156 CLIA NUMBER - NEW VITAE MOUNT TREXLER MANOR

Laboratory Demographics

CLIA Number: 39D2117156

Facility Name: NEW VITAE MOUNT TREXLER MANOR

Facility Address:
5201 ST JOSEPH'S ROAD
LIMEPORT, PA
ZIP 18060
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Facility Phone Number: 610 965-9021

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1538515564

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	39D2117156
LAB Type	Assisted Living Facility
Facility Name	NEW VITAE MOUNT TREXLER MANOR
Street	5201 ST JOSEPH'S ROAD
City	LIMEPORT
State	PA
ZIP	18060
Phone	610 965-9021
CertificateType	4
CertificateEffectiveDate	8/10/2022
CertificateExpirationDate	8/9/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024