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General NPI Number Information
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NPI Number | 1457668741
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Entity Type | Organization
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Legal Business Name | STAGES FAMILY SERVICES
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 413 RT 940 SUITE 334
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City | MT. POCONO
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State | PA
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Zip | 18344
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Country | US
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Telephone | 347-277-7524
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Fax | 570-894-8316
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Provider Business Mailing Address
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Address Line | 413 RT 940 SUITE 334
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City | MT. POCONO
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State | PA
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Zip | 18344
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Country | US
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Telephone | 347-277-7524
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Fax | 570-894-8316
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. SHARON PURVIS
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Credential | MSW
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Telephone | 347-277-7524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State | PA
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