Provider Demographics
NPI:1457668741
Name:STAGES FAMILY SERVICES
Entity Type:Organization
Organization Name:STAGES FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PURVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:347-277-7524
Mailing Address - Street 1:413 RT 940 SUITE 334
Mailing Address - Street 2:
Mailing Address - City:MT. POCONO
Mailing Address - State:PA
Mailing Address - Zip Code:18344
Mailing Address - Country:US
Mailing Address - Phone:347-277-7524
Mailing Address - Fax:570-894-8316
Practice Address - Street 1:413 RT 940 SUITE 334
Practice Address - Street 2:
Practice Address - City:MT. POCONO
Practice Address - State:PA
Practice Address - Zip Code:18344
Practice Address - Country:US
Practice Address - Phone:347-277-7524
Practice Address - Fax:570-894-8316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty