Provider Demographics
NPI:1376177147
Name:SARAH A. REED CHILDREN'S CENTER
Entity Type:Organization
Organization Name:SARAH A. REED CHILDREN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AVP OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:SHALLENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-835-7621
Mailing Address - Street 1:2445 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-3599
Mailing Address - Country:US
Mailing Address - Phone:814-835-7621
Mailing Address - Fax:
Practice Address - Street 1:1611 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-2109
Practice Address - Country:US
Practice Address - Phone:814-480-8985
Practice Address - Fax:814-840-8947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-02
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health