Healthcare Provider Details

I. General information

NPI: 1891780870
Provider Name (Legal Business Name): FAMILY HEALTH COUNCIL OF CENTRAL PA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MATCH FACTORY PL
BELLEFONTE PA
16823-1366
US

IV. Provider business mailing address

240 MATCH FACTORY PL
BELLEFONTE PA
16823-1366
US

V. Phone/Fax

Practice location:
  • Phone: 814-355-2762
  • Fax: 814-355-8740
Mailing address:
  • Phone: 814-355-2762
  • Fax: 814-355-8740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: KELLI L MUSSER
Title or Position: CLINIC ASSOCIATE
Credential:
Phone: 814-355-5472