| Project Starphish | |
|
10987 Route 322 Shippenville PA 16254-4837 | |
| (814) 661-2780 | |
| Not Available |
| Full Name | Project Starphish |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 10987 Route 322, Shippenville, Pennsylvania |
| Authorized Official Name and Position | Leslie M Randolph (ADMINISTRATOR OF PROGRAM SUPPORT) |
| Authorized Official Contact | 8146612780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Project Starphish Po Box 771 Clarion PA 16214-0771 Ph: (814) 661-2780 | Project Starphish 10987 Route 322 Shippenville PA 16254-4837 Ph: (814) 661-2780 |
| NPI Number | 1831536853 |
|---|---|
| Provider Enumeration Date | 05/31/2013 |
| Last Update Date | 05/31/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831536853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 444590 (Pennsylvania) | Primary |
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