Provider Demographics
NPI:1568655157
Name:TRUENORTH WELLNESS SERVICES
Entity Type:Organization
Organization Name:TRUENORTH WELLNESS SERVICES
Other - Org Name:ADAMS HANOVER COUNSELING SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:COORDINATOR OF MIS/NETWORKING
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:EYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:171-632-4900
Mailing Address - Street 1:625 W ELM AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-5125
Mailing Address - Country:US
Mailing Address - Phone:717-632-4900
Mailing Address - Fax:717-632-1942
Practice Address - Street 1:33 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-3502
Practice Address - Country:US
Practice Address - Phone:717-632-4900
Practice Address - Fax:717-632-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA349280251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100744641Medicaid