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General NPI Number Information
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NPI Number | 1154547586
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Entity Type | Organization
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Legal Business Name | COMMUNITY GUIDANCE CENTER
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 450 CENTRAL STREET
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City | ROSSITER
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State | PA
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Zip | 15772
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Country | US
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Telephone | 724-465-5576
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Fax | 724-463-3262
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Provider Business Mailing Address
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Address Line | 793 OLD ROUTE 119 HWY N
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City | INDIANA
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State | PA
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Zip | 15701-1372
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Country | US
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Telephone | 724-465-5576
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Fax | 724-463-3262
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | KAREN H. FORSHA
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Credential | B.S. EDUCATIONS
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Telephone | 724-465-5576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 421220
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License Number State | PA
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