| Diakon Child, Family & Community Ministries | |
|
1500 Cherry St Williamsport PA 17701-2169 | |
| (570) 322-7873 | |
| (570) 322-8026 |
| Full Name | Diakon Child, Family & Community Ministries |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1500 Cherry St, 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 1500 Cherry St Williamsport PA 17701-2169 Ph: (570) 322-7873 |
| NPI Number | 1700384476 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 01/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700384476 | NPI | - | NPPES |
| 33160-0 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 33160-0 (Pennsylvania) | Primary |
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