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General NPI Number Information
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NPI Number | 1912966805
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Entity Type | Organization
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Legal Business Name | TRI COUNTY HUMAN SERVICES CENTER INC
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 185 FALLBROOK ST
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City | CARBONDALE
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State | PA
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Zip | 18407-0514
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Country | US
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Telephone | 570-282-1732
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Fax | 570-282-6808
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Provider Business Mailing Address
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Address Line | 185 FALLBROOK ST
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City | CARBONDALE
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State | PA
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Zip | 18407-0514
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Country | US
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Telephone | 570-282-1732
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Fax | 570-282-6808
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. SPENCER A MOORE
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Credential |
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Telephone | 570-282-1732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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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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Taxonomy #4
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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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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Taxonomy #7
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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