Healthcare Provider Details

I. General information

NPI: 1295912616
Provider Name (Legal Business Name): CENTER FOR FAMILY ATTACHMENT AND HEALING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 GREEN ST
CAMP HILL PA
17011-4319
US

IV. Provider business mailing address

3525 GREEN ST
CAMP HILL PA
17011-4319
US

V. Phone/Fax

Practice location:
  • Phone: 717-856-1750
  • Fax: 717-975-2055
Mailing address:
  • Phone: 717-856-1750
  • Fax: 717-975-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberSW124212
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberSW124212
License Number StatePA

VIII. Authorized Official

Name: PAMELA SUE MORAN
Title or Position: OWNER/DIRECTOR
Credential: MSW, LSW
Phone: 717-856-1750