Provider Demographics
NPI:1639579147
Name:GROUP WORKS, LLC
Entity Type:Organization
Organization Name:GROUP WORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-218-0551
Mailing Address - Street 1:32 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1338
Mailing Address - Country:US
Mailing Address - Phone:814-218-0551
Mailing Address - Fax:
Practice Address - Street 1:32 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1338
Practice Address - Country:US
Practice Address - Phone:814-218-0551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0156481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty