| Diakon Child,family&community Ministries | |
|
1801 Loyalsock Dr Williamsport PA 17701-2829 | |
| (570) 322-7873 | |
| (570) 322-8026 |
| Full Name | Diakon Child,family&community Ministries |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1801 Loyalsock Dr, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Deborah P White (DIRECTOR OF ADMINISTRATIVE OPS) |
| Authorized Official Contact | 5703227878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diakon Child,family&community Ministries 435 W 4th St Williamsport PA 17701-6001 Ph: (570) 322-7873 | Diakon Child,family&community Ministries 1801 Loyalsock Dr Williamsport PA 17701-2829 Ph: (570) 322-7873 |
| NPI Number | 1174021836 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 01/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174021836 | NPI | - | NPPES |
| 102920256-0001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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