| Diakon Child Family And Community Ministries | |
|
2990 W 4th St Williamsport PA 17701-4197 | |
| (570) 322-7873 | |
| Not Available |
| Full Name | Diakon Child Family And Community Ministries |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2990 W 4th St, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Laurel Spencer (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5703227873 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diakon Child Family And Community Ministries 435 W 4th St Williamsport PA 17701-6001 Ph: () - | Diakon Child Family And Community Ministries 2990 W 4th St Williamsport PA 17701-4197 Ph: (570) 322-7873 |
| NPI Number | 1548631583 |
|---|---|
| Provider Enumeration Date | 10/16/2015 |
| Last Update Date | 10/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548631583 | NPI | - | NPPES |
| 379904 | Other | PA | MEDICARE PTAN |
| 1029202560001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 331600 (Pennsylvania) | Primary |
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