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General NPI Number Information
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NPI Number | 1730231333
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES OF THE DIOCESE OF HARRISBURG PA INC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 939 E PARK DR STE 101
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City | HARRISBURG
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State | PA
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Zip | 17111-2815
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Country | US
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Telephone | 717-657-4804
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Fax | 717-657-8683
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Provider Business Mailing Address
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Address Line | 4800 UNION DEPOSIT RD
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City | HARRISBURG
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State | PA
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Zip | 17111-3551
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Country | US
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Telephone | 717-657-4804
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Fax | 717-657-8683
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KELLY GOLLICK
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Credential | MSW
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Telephone | 717-657-4804
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 309960
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License Number State | PA
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Taxonomy #3
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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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