Provider Demographics
NPI:1881014785
Name:CLEAN AND SOBER HUMANS ASSOC., INC.
Entity Type:Organization
Organization Name:CLEAN AND SOBER HUMANS ASSOC., INC.
Other - Org Name:C.A.S.H. CLUB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PANFILO
Authorized Official - Middle Name:
Authorized Official - Last Name:DICENZO
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:412-875-0020
Mailing Address - Street 1:827 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-2227
Mailing Address - Country:US
Mailing Address - Phone:412-875-0020
Mailing Address - Fax:412-331-3718
Practice Address - Street 1:827 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-2227
Practice Address - Country:US
Practice Address - Phone:412-875-0020
Practice Address - Fax:412-331-3718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management