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General NPI Number Information
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NPI Number | 1588183552
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Entity Type | Organization
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Legal Business Name | ON COMMON GROUND, LLC
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2645 CARNEGIE RD STE 1
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City | YORK
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State | PA
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Zip | 17402-3790
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Country | US
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Telephone | 717-654-5619
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Fax | 717-654-5619
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Provider Business Mailing Address
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Address Line | 2645 CARNEGIE RD STE 1
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City | YORK
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State | PA
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Zip | 17402-3790
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Country | US
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Telephone | 717-654-5619
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Fax | 717-654-5619
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | SHERLYN YOUNG
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Credential |
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Telephone | 717-654-5619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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