Provider Demographics
NPI:1669185112
Name:CLEARFIELD EDUCATIONAL FOUNDATION-FUTURE CORPORATION
Entity type:Organization
Organization Name:CLEARFIELD EDUCATIONAL FOUNDATION-FUTURE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:814-205-4077
Mailing Address - Street 1:PO BOX 209
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-0209
Mailing Address - Country:US
Mailing Address - Phone:814-205-4077
Mailing Address - Fax:
Practice Address - Street 1:8904 CLEARFIELD CURWENSVILLE HWY
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3520
Practice Address - Country:US
Practice Address - Phone:814-205-4077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-29
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)