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General NPI Number Information
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NPI Number | 1730433855
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Entity Type | Organization
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Legal Business Name | SUPPORTS COORDINATION OF NORTHWEST PENNSYLVANIA, INC.
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 2700 WEST 21ST STREET SUITE 24
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City | ERIE
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State | PA
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Zip | 16506-6916
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Country | US
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Telephone | 814-464-0593
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Fax | 814-874-5089
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Provider Business Mailing Address
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Address Line | 2700 W 21ST ST SUITE 24
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City | ERIE
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State | PA
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Zip | 16506-2972
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Country | US
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Telephone | 814-464-0593
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Fax | 814-874-5089
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Authorized Official
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Title or Position | DIRECTOR
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Name | LORI FOSTER
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Credential |
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Telephone | 814-464-0593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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