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General NPI Number Information
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NPI Number | 1326205170
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Entity Type | Organization
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Legal Business Name | PENNSYLVANIA ASSESSMENT CONSULTANTS FOR CO OCCURRING DISORDERS LLC
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 11/18/2009
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Provider Practice Location Address
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Address Line | 2030 CENTER ST. PLAZA SUITE 104,
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City | NORTHAMPTON, PA 18067
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State | PA
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Zip | 18067
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Country | US
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Telephone | 610-262-6999
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Fax | 610-262-6990
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Provider Business Mailing Address
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Address Line | 2030 CENTER ST. PLAZA SUITE 104,
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City | NORTHAMPTON, PA 18067
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State | PA
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Zip | 18067
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Country | US
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Telephone | 610-262-6999
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Fax | 610-262-6990
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. MILTON LEONARDO REYES
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Credential | BA, CAC
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Telephone | 610-262-6999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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