Provider Demographics
NPI:1205388543
Name:PA CHLD CORP
Entity Type:Organization
Organization Name:PA CHLD CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EI CASE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:717-818-7528
Mailing Address - Street 1:4160 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-5934
Mailing Address - Country:US
Mailing Address - Phone:717-850-3662
Mailing Address - Fax:
Practice Address - Street 1:4160 W MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-5934
Practice Address - Country:US
Practice Address - Phone:717-850-3662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty