Provider Demographics
NPI:1689799629
Name:VENANGO COUNTY SUBSTANCE USE DISORDER
Entity Type:Organization
Organization Name:VENANGO COUNTY SUBSTANCE USE DISORDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN SERVICES ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-432-9163
Mailing Address - Street 1:1 DALE AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-2301
Mailing Address - Country:US
Mailing Address - Phone:814-432-9163
Mailing Address - Fax:814-432-9150
Practice Address - Street 1:1 DALE AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-2301
Practice Address - Country:US
Practice Address - Phone:814-432-9163
Practice Address - Fax:814-432-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAX21524Medicare UPIN