Provider Demographics
NPI:1649626482
Name:DIAKON CHILD,FAMILY&COMMUNITY MINISTRIES
Entity type:Organization
Organization Name:DIAKON CHILD,FAMILY&COMMUNITY MINISTRIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:T
Authorized Official - Last Name:PILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-682-1262
Mailing Address - Street 1:960 CENTURY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4530
Mailing Address - Country:US
Mailing Address - Phone:717-795-0368
Mailing Address - Fax:717-795-9407
Practice Address - Street 1:960 CENTURY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4530
Practice Address - Country:US
Practice Address - Phone:717-795-0368
Practice Address - Fax:717-795-9407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA331610251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health