Provider Demographics
NPI:1891780870
Name:FAMILY HEALTH COUNCIL OF CENTRAL PA, INC.
Entity Type:Organization
Organization Name:FAMILY HEALTH COUNCIL OF CENTRAL PA, INC.
Other - Org Name:CENTREHUNTINGDON TAPESTRY OF HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-355-5472
Mailing Address - Street 1:240 MATCH FACTORY PL
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-1366
Mailing Address - Country:US
Mailing Address - Phone:814-355-2762
Mailing Address - Fax:814-355-8740
Practice Address - Street 1:240 MATCH FACTORY PL
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1366
Practice Address - Country:US
Practice Address - Phone:814-355-2762
Practice Address - Fax:814-355-8740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3000014OtherKEYSTONE HEALTH PLAN CENT
PA50018438OtherCAPITAL BLUE CROSS
PAFM1634774OtherHIGHMARK
PA085828Medicare PIN