Provider Demographics
NPI:1134458276
Name:INDIVIDUAL AND FAMILY CHOICES PROGRAM
Entity Type:Organization
Organization Name:INDIVIDUAL AND FAMILY CHOICES PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:EHRMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:814-237-0567
Mailing Address - Street 1:2214 N ATHERTON ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-1544
Mailing Address - Country:US
Mailing Address - Phone:814-237-0567
Mailing Address - Fax:814-237-0569
Practice Address - Street 1:2214 N ATHERTON ST
Practice Address - Street 2:SUITE 4
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-1544
Practice Address - Country:US
Practice Address - Phone:814-237-0567
Practice Address - Fax:814-237-0569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health