Provider Demographics
NPI:1790383628
Name:NEW VISIONS OF SOUTH CENTRAL PA, INC.
Entity Type:Organization
Organization Name:NEW VISIONS OF SOUTH CENTRAL PA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CORDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-477-2153
Mailing Address - Street 1:138 E KING ST
Mailing Address - Street 2:
Mailing Address - City:SHIPPENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17257-1329
Mailing Address - Country:US
Mailing Address - Phone:717-477-2153
Mailing Address - Fax:717-477-2295
Practice Address - Street 1:138 E KING ST
Practice Address - Street 2:
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-1329
Practice Address - Country:US
Practice Address - Phone:717-477-2153
Practice Address - Fax:717-477-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness