Provider Demographics
NPI:1992017586
Name:PRESSLEY RIDGE
Entity Type:Organization
Organization Name:PRESSLEY RIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWCOMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-238-8118
Mailing Address - Street 1:121 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101-1411
Mailing Address - Country:US
Mailing Address - Phone:717-238-8118
Mailing Address - Fax:717-238-8140
Practice Address - Street 1:121 LOCUST ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-1411
Practice Address - Country:US
Practice Address - Phone:717-238-8118
Practice Address - Fax:717-238-8140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW126836251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health