The Open Door | |
665 Philadelphia St Ste 202 Indiana PA 15701-3941 | |
(724) 465-2605 | |
(724) 465-2610 |
Full Name | The Open Door |
---|---|
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 665 Philadelphia St Ste 202, Indiana, Pennsylvania |
Authorized Official Name and Position | Judith Wolfe (CHIEF COMPLIANCE OFFICER) |
Authorized Official Contact | 7244652605 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
The Open Door 665 Philadelphia St Ste 202 Indiana PA 15701-3941 Ph: (724) 465-2605 | The Open Door 665 Philadelphia St Ste 202 Indiana PA 15701-3941 Ph: (724) 465-2605 |
NPI Number | 1487710828 |
---|---|
Provider Enumeration Date | 12/29/2006 |
Last Update Date | 01/03/2023 |
Certification Date | 01/03/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487710828 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 321050 (Pennsylvania) | Primary |
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