Provider Demographics
NPI:1871832220
Name:EASTER SEALS CENTRAL PA
Entity Type:Organization
Organization Name:EASTER SEALS CENTRAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-689-1911
Mailing Address - Street 1:383 ROLLING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7679
Mailing Address - Country:US
Mailing Address - Phone:814-689-1911
Mailing Address - Fax:
Practice Address - Street 1:2550 KINGSTON RD
Practice Address - Street 2:SUITE 219
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3735
Practice Address - Country:US
Practice Address - Phone:717-718-3512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health