Healthcare Provider Details

I. General information

NPI: 1851312045
Provider Name (Legal Business Name): LYTLE BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 S MONTGOMERY ST
HOLLIDAYSBURG PA
16648-1738
US

IV. Provider business mailing address

15 S MONTGOMERY ST
HOLLIDAYSBURG PA
16648-1738
US

V. Phone/Fax

Practice location:
  • Phone: 814-696-3277
  • Fax: 814-695-5307
Mailing address:
  • Phone: 814-696-3277
  • Fax: 814-695-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StatePA

VIII. Authorized Official

Name: STEVEN E LYTLE
Title or Position: OWNER CHAIRMAN CEO
Credential:
Phone: 814-696-3277