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General NPI Number Information
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NPI Number | 1184773475
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Entity Type | Organization
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Legal Business Name | TWIN TREES INC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 201 E FAIRVIEW AVE
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3703
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Country | US
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Telephone | 724-628-5353
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Fax | 724-628-1301
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Provider Business Mailing Address
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Address Line | 201 E FAIRVIEW AVE
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3703
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Country | US
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Telephone | 724-628-5353
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Fax | 724-628-1301
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Authorized Official
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Title or Position | CEO
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Name | JOHN KING
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Credential |
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Telephone | 724-628-5353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 425200
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License Number State | PA
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