Provider Demographics
NPI:1932732518
Name:PEER ASSOCIATES LLC
Entity Type:Organization
Organization Name:PEER ASSOCIATES LLC
Other - Org Name:PEERCOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:NULTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:814-262-0025
Mailing Address - Street 1:117 W GAY ST STE 336
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-2938
Mailing Address - Country:US
Mailing Address - Phone:814-262-0025
Mailing Address - Fax:814-262-6166
Practice Address - Street 1:117 W GAY ST STE 336
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2938
Practice Address - Country:US
Practice Address - Phone:814-262-0025
Practice Address - Fax:814-262-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA145510Medicaid