| Perseus House, Inc | |
|
1510 State St Erie PA 16501-2220 | |
| (814) 480-5905 | |
| (814) 456-4229 |
| Full Name | Perseus House, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1510 State St, Erie, Pennsylvania |
| Authorized Official Name and Position | Mark Amendola (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8144805956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Perseus House, Inc 1511 Peach St Erie PA 16501-2104 Ph: (814) 480-5911 | Perseus House, Inc 1510 State St Erie PA 16501-2220 Ph: (814) 480-5905 |
| NPI Number | 1255480174 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 03/02/2022 |
| Certification Date | 03/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255480174 | NPI | - | NPPES |
| 407390 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 407390 (Pennsylvania) | Primary |
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