Provider Demographics
NPI:1003028291
Name:MIFFLIN-JUNIATA SPECIAL NEEDS CENTER, INC.
Entity Type:Organization
Organization Name:MIFFLIN-JUNIATA SPECIAL NEEDS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:ZONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-248-6261
Mailing Address - Street 1:31 S DORCAS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-2110
Mailing Address - Country:US
Mailing Address - Phone:717-248-6261
Mailing Address - Fax:717-248-6264
Practice Address - Street 1:31 S DORCAS ST
Practice Address - Street 2:SUITE A
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-2110
Practice Address - Country:US
Practice Address - Phone:717-248-6261
Practice Address - Fax:717-248-6264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000009610007Medicaid
PA1000009610015Medicaid