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General NPI Number Information
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NPI Number | 1598202848
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Entity Type | Organization
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Legal Business Name | CHILD DEVELOPMENT CENTERS, INC.
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 155 E BISSELL AVE
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City | OIL CITY
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State | PA
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Zip | 16301-1903
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Country | US
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Telephone | 814-437-7288
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Fax |
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Provider Business Mailing Address
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Address Line | 631 12TH ST
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City | FRANKLIN
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State | PA
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Zip | 16323-1440
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Country | US
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Telephone | 814-437-7288
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Fax | 888-779-7763
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. RINA IRWIN
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Credential |
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Telephone | 814-437-7288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC006496
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD049022L
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License Number State | PA
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