Provider Demographics
NPI:1255397436
Name:RICHARD J CARON FOUNDATION
Entity type:Organization
Organization Name:RICHARD J CARON FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR DIRECTOR PATIENT FINANCIAL SERVI
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CURRENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-743-6141
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:GALEN HALL RD
Mailing Address - City:WERNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19565-0150
Mailing Address - Country:US
Mailing Address - Phone:800-678-2332
Mailing Address - Fax:
Practice Address - Street 1:845 N PARK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1342
Practice Address - Country:US
Practice Address - Phone:800-678-2332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA067025101YA0400X
261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0942000OtherMEDICAL ASSISTANCE NUMBER