Provider Demographics
NPI:1346461381
Name:NORTH PENN COMPREHENSIVE HEALTH SERVICES
Entity Type:Organization
Organization Name:NORTH PENN COMPREHENSIVE HEALTH SERVICES
Other - Org Name:LAUREL BEHAVIORAL HEALTH OUTPATIENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:MERYL
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-662-1955
Mailing Address - Street 1:7 WATER ST
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-1126
Mailing Address - Country:US
Mailing Address - Phone:570-723-0620
Mailing Address - Fax:570-724-0675
Practice Address - Street 1:105 WEST AVE
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1358
Practice Address - Country:US
Practice Address - Phone:570-723-0620
Practice Address - Fax:570-724-0675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health