Provider Demographics
NPI:1619195401
Name:HUNTINGDON COUNTY PRIDE, INC.
Entity Type:Organization
Organization Name:HUNTINGDON COUNTY PRIDE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-643-5724
Mailing Address - Street 1:1301 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-1149
Mailing Address - Country:US
Mailing Address - Phone:814-643-5724
Mailing Address - Fax:814-643-6058
Practice Address - Street 1:1301 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-1149
Practice Address - Country:US
Practice Address - Phone:814-643-5724
Practice Address - Fax:814-643-6058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA75035522251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable