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General NPI Number Information
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NPI Number | 1790383628
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Entity Type | Organization
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Legal Business Name | NEW VISIONS OF SOUTH CENTRAL PA, INC.
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 138 E KING ST
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City | SHIPPENSBURG
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State | PA
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Zip | 17257-1329
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Country | US
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Telephone | 717-477-2153
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Fax | 717-477-2295
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Provider Business Mailing Address
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Address Line | 138 E KING ST
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City | SHIPPENSBURG
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State | PA
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Zip | 17257-1329
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Country | US
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Telephone | 717-477-2153
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Fax | 717-477-2295
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. CRAIG ALAN CORDELL
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Credential |
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Telephone | 717-477-2153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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