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General NPI Number Information
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NPI Number | 1427179654
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Entity Type | Organization
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Legal Business Name | CHILDREN'S CENTER FOR TREATMENT AND EDUCATION
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 945 SOUTH AVE
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City | CUSTER CITY
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State | PA
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Zip | 16725
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Country | US
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Telephone | 814-362-5250
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Fax |
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Provider Business Mailing Address
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Address Line | 800 E MAIN ST
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City | BRADFORD
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State | PA
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Zip | 16701-3278
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | TIM BEAN
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Credential |
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Telephone | 814-362-5250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 461140
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License Number State | PA
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