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General NPI Number Information
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NPI Number | 1104806793
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Entity Type | Organization
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Legal Business Name | CRAWFORD COUNTY DRUG & ALCOHOL EXECUTIVE COMMISSION, INC.
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 08/03/2007
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Provider Practice Location Address
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Address Line | 920 WATER ST DOWNTOWN MALL
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City | MEADVILLE
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State | PA
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Zip | 16335-3439
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Country | US
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Telephone | 814-724-4100
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Fax | 814-333-2779
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Provider Business Mailing Address
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Address Line | 920 WATER ST DOWNTOWN MALL
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City | MEADVILLE
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State | PA
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Zip | 16335-3439
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Country | US
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Telephone | 814-724-4100
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Fax | 814-333-2779
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DEBORAH J. DUFFY
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Credential |
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Telephone | 814-724-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 201084
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 201084
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License Number State | PA
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