Provider Demographics
NPI:1811203151
Name:COUNTY SEAT BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:COUNTY SEAT BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:S
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSW, LCSW, CAC
Authorized Official - Phone:610-565-2690
Mailing Address - Street 1:210 W FRONT ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3147
Mailing Address - Country:US
Mailing Address - Phone:610-565-2690
Mailing Address - Fax:610-565-2695
Practice Address - Street 1:210 W FRONT ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3147
Practice Address - Country:US
Practice Address - Phone:610-565-2690
Practice Address - Fax:610-565-2695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA237091251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health