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General NPI Number Information
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NPI Number | 1821455296
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Entity Type | Organization
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Legal Business Name | A FEW GOOD LEADERS
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 26 S 2ND ST STE 101A
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City | CLEARFIELD
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State | PA
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Zip | 16830-2346
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Country | US
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Telephone | 814-441-4112
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Fax |
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Provider Business Mailing Address
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Address Line | 923 GOOD ST
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City | HOUTZDALE
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State | PA
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Zip | 16651-1308
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Country | US
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Telephone | 814-441-4112
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BAREN LYNN BERG
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Credential | MS, CPS
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Telephone | 814-441-4112
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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 | 447310
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License Number State | PA
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