Provider Demographics
NPI:1477623429
Name:THE GUIDANCE CENTER
Entity Type:Organization
Organization Name:THE GUIDANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF PROV AND COMMUNITY RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-362-6535
Mailing Address - Street 1:110 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-1982
Mailing Address - Country:US
Mailing Address - Phone:814-362-6535
Mailing Address - Fax:814-362-7358
Practice Address - Street 1:110 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1982
Practice Address - Country:US
Practice Address - Phone:814-362-6535
Practice Address - Fax:814-362-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA463960251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100002643Medicaid