| Diakon Family Life Services | |
|
1100 Montour Rd Loysville PA 17047-9200 | |
| (717) 795-0330 | |
| (717) 795-0407 |
| Full Name | Diakon Family Life Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1100 Montour Rd, Loysville, Pennsylvania |
| Authorized Official Name and Position | Rita A. Rousseau (EXECUTIVE DIRECTOR COS) |
| Authorized Official Contact | 7177950368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diakon Family Life Services 435 W 4th St Williamsport PA 17701-6001 Ph: (570) 322-7873 | Diakon Family Life Services 1100 Montour Rd Loysville PA 17047-9200 Ph: (717) 795-0330 |
| NPI Number | 1033148630 |
|---|---|
| Provider Enumeration Date | 07/03/2006 |
| Last Update Date | 10/25/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033148630 | NPI | - | NPPES |
| 1526223 | Other | PA | PA BLUE SHIELD - CRNP |
| 1007777400059 | Medicaid | PA | |
| 02319100 | Other | PA | CAPITAL BLUE CROSS |
| 301029 | Other | PA | VALUEOPTIONS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |