Provider Demographics
NPI:1659594679
Name:VENANGO TRAINING & DEVELOPMENT CENTER, INC.
Entity Type:Organization
Organization Name:VENANGO TRAINING & DEVELOPMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:STUART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-676-5755
Mailing Address - Street 1:239 QUAKER DR.
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346-2417
Mailing Address - Country:US
Mailing Address - Phone:814-676-5755
Mailing Address - Fax:814-676-9563
Practice Address - Street 1:239 QUAKER DR.
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-2417
Practice Address - Country:US
Practice Address - Phone:814-676-5755
Practice Address - Fax:814-676-9563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA401070251C00000X
PA419680251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000045120001OtherDPW MA NUMBER