Healthcare Provider Details
I. General information
NPI: 1760685432
Provider Name (Legal Business Name): CENTER FOR HEALING & REHABILITATION IN SUBSTANCE ABUSE TREATMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
333 STATE ST SUITE 206
ERIE PA
16507-1450
US
IV. Provider business mailing address
717 STATE ST SUITE 16, LL
ERIE PA
16501-1341
US
V. Phone/Fax
- Phone: 814-877-5295
- Fax: 814-877-5299
- Phone: 814-480-7100
- Fax: 814-480-7604
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANTHONY
RUFFA
Title or Position: PHYSICIAN
Credential: MD
Phone: 814-877-5295