Healthcare Provider Details

I. General information

NPI: 1780631184
Provider Name (Legal Business Name): MONYOUGH COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 SAXONY DR
HARRISON CITY PA
15636-1510
US

IV. Provider business mailing address

23 SAXONY DR
HARRISON CITY PA
15636-1510
US

V. Phone/Fax

Practice location:
  • Phone: 724-744-7186
  • Fax:
Mailing address:
  • Phone: 724-744-7186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberSW124866
License Number StatePA

VIII. Authorized Official

Name: MS. MARGARET E BROWN
Title or Position: THERAPIST
Credential: LSW
Phone: 417-675-8855