Provider Demographics
NPI:1003941949
Name:WEST BRANCH DRUG AND ALCOHOL ABUSE COMMISSION
Entity Type:Organization
Organization Name:WEST BRANCH DRUG AND ALCOHOL ABUSE COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-323-8543
Mailing Address - Street 1:213 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-6148
Mailing Address - Country:US
Mailing Address - Phone:570-323-8543
Mailing Address - Fax:570-323-8550
Practice Address - Street 1:213 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6148
Practice Address - Country:US
Practice Address - Phone:570-323-8543
Practice Address - Fax:570-323-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management