Healthcare Provider Details

I. General information

NPI: 1942733175
Provider Name (Legal Business Name): TIOGA COUNTY COMMISSIONERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1873 SHUMWAY HILL RD
WELLSBORO PA
16901-6840
US

IV. Provider business mailing address

1873 SHUMWAY HILL RD
WELLSBORO PA
16901-6840
US

V. Phone/Fax

Practice location:
  • Phone: 570-724-5766
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NANCY CLEMENS
Title or Position: ADMINISTRATOR
Credential:
Phone: 570-724-5766