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General NPI Number Information
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NPI Number | 1699396804
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Entity Type | Organization
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Legal Business Name | ERIE FAMILY CENTER
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 04/28/2020
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Provider Practice Location Address
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Address Line | 606 RASPBERRY ST
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City | ERIE
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State | PA
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Zip | 16502-1123
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Country | US
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Telephone | 814-520-8214
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Fax | 814-528-5028
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Provider Business Mailing Address
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Address Line | 606 RASPBERRY ST
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City | ERIE
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State | PA
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Zip | 16502-1123
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Country | US
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Telephone | 814-520-8214
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Fax | 814-528-5028
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KRISTEN COSTA
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Credential |
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Telephone | 814-520-8214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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