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General NPI Number Information
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NPI Number | 1932846367
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Entity Type | Organization
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Legal Business Name | SAEGERTOWN RECOVERY CLINIC, LLC
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 707 ERIE ST
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City | SAEGERTOWN
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State | PA
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Zip | 16433-5003
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Country | US
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Telephone | 814-763-2010
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Fax | 814-763-5535
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Provider Business Mailing Address
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Address Line | 707 ERIE ST
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City | SAEGERTOWN
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State | PA
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Zip | 16433-5003
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Country | US
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Telephone | 814-763-2010
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Fax | 814-763-5535
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Authorized Official
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Title or Position | OWNER
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Name | DR. JILL C MILLER
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Credential | DO
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Telephone | 814-763-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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