Provider Demographics
NPI:1629298104
Name:CO-COUNTY WELLNESS SERVICES
Entity Type:Organization
Organization Name:CO-COUNTY WELLNESS SERVICES
Other - Org Name:BERKS AIDS NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAZIK
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:610-375-6523
Mailing Address - Street 1:429 WALNUT ST
Mailing Address - Street 2:PO BOX 8626
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3929
Mailing Address - Country:US
Mailing Address - Phone:610-375-6523
Mailing Address - Fax:610-375-8333
Practice Address - Street 1:429 WALNUT ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3929
Practice Address - Country:US
Practice Address - Phone:610-375-6523
Practice Address - Fax:610-375-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management