Provider Demographics
NPI:1619741501
Name:ASCEND MINISTRIES WITHDRAWAL MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:ASCEND MINISTRIES WITHDRAWAL MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-933-4181
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:REHRERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19550-0098
Mailing Address - Country:US
Mailing Address - Phone:717-933-4181
Mailing Address - Fax:
Practice Address - Street 1:33 TEEN CHALLENGE RD
Practice Address - Street 2:
Practice Address - City:REHRERSBURG
Practice Address - State:PA
Practice Address - Zip Code:19550-5000
Practice Address - Country:US
Practice Address - Phone:717-933-4181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCEND MINISTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder