Provider Demographics
NPI:1346430147
Name:WARDELL AND ASSOCIATES
Entity Type:Organization
Organization Name:WARDELL AND ASSOCIATES
Other - Org Name:FAMILY INTERVENTION CRISIS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PUPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-696-7327
Mailing Address - Street 1:1311 ALLEGHENY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648
Mailing Address - Country:US
Mailing Address - Phone:814-696-7327
Mailing Address - Fax:
Practice Address - Street 1:1311 ALLEGHENY ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648
Practice Address - Country:US
Practice Address - Phone:814-696-7327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017744850001OtherMEDICAL ASSISTANCE