Provider Demographics
NPI:1881119493
Name:CORE TREATMENT SERVICES, LLC
Entity type:Organization
Organization Name:CORE TREATMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:609-332-9967
Mailing Address - Street 1:555 ANDORRA GLEN CT STE 7
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-2531
Mailing Address - Country:US
Mailing Address - Phone:609-332-9967
Mailing Address - Fax:
Practice Address - Street 1:555 ANDORRA GLEN CT STE 7
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-2531
Practice Address - Country:US
Practice Address - Phone:609-332-9967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006334261QM0855X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health