Provider Demographics
NPI:1942880117
Name:BETHANY CHRISTIAN SERVICES
Entity Type:Organization
Organization Name:BETHANY CHRISTIAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOUTMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-224-7429
Mailing Address - Street 1:2147 E COLLEGE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7204
Mailing Address - Country:US
Mailing Address - Phone:814-867-2828
Mailing Address - Fax:814-867-2828
Practice Address - Street 1:2147 E COLLEGE AVE STE A
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7204
Practice Address - Country:US
Practice Address - Phone:814-867-2828
Practice Address - Fax:814-867-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty