Provider Demographics
NPI:1497926752
Name:ALBRIGHT COMMUNITY SERVICES
Entity Type:Organization
Organization Name:ALBRIGHT COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-522-3889
Mailing Address - Street 1:90 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-6307
Mailing Address - Country:US
Mailing Address - Phone:570-522-3880
Mailing Address - Fax:570-524-9068
Practice Address - Street 1:90 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6307
Practice Address - Country:US
Practice Address - Phone:570-522-3880
Practice Address - Fax:570-524-9068
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBRIGHT CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100006885 0001Medicaid