Provider Demographics
NPI:1609901412
Name:PENNCARES
Entity Type:Organization
Organization Name:PENNCARES
Other - Org Name:UNITED CEREBRAL PALSY OF SOUTH CENTRAL PA, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF CHILDREN'S PROGRAMS
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSSERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-632-5552
Mailing Address - Street 1:788 CHERRY TREE CT
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-7901
Mailing Address - Country:US
Mailing Address - Phone:717-632-5552
Mailing Address - Fax:717-632-2315
Practice Address - Street 1:788 CHERRY TREE CT
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-7901
Practice Address - Country:US
Practice Address - Phone:717-632-5552
Practice Address - Fax:717-632-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable