Provider Demographics
NPI:1093185654
Name:CRISIS SHELTER OF LAWRENCE COUNTY
Entity Type:Organization
Organization Name:CRISIS SHELTER OF LAWRENCE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HENNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-856-4300
Mailing Address - Street 1:1218 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-2021
Mailing Address - Country:US
Mailing Address - Phone:724-652-9206
Mailing Address - Fax:724-652-9222
Practice Address - Street 1:1218 W STATE ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-2021
Practice Address - Country:US
Practice Address - Phone:724-652-9206
Practice Address - Fax:724-652-9222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health