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General NPI Number Information
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NPI Number | 1003291725
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Entity Type | Organization
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Legal Business Name | JOURNEY CENTER
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 07/23/2015
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Provider Practice Location Address
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Address Line | 224 BEDFORD ST
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City | HOLLIDAYSBURG
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State | PA
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Zip | 16648-1716
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Country | US
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Telephone | 814-977-5345
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Fax |
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Provider Business Mailing Address
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Address Line | 87 CASNER LN
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City | LEWISTOWN
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State | PA
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Zip | 17044-9324
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Country | US
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Telephone | 717-994-4115
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Fax |
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Authorized Official
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Title or Position | OWNER/BCBA
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Name | KIMBERLY BENNETT
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Credential | BCBA
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Telephone | 814-977-5345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SW131298
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License Number State | PA
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