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General NPI Number Information
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NPI Number | 1982263877
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Entity Type | Organization
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Legal Business Name | MESSIAH LIFEWAYS COMMUNITY SUPPORT SERVICES
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 06/13/2019
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Provider Practice Location Address
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Address Line | 1155 WALNUT BOTTOM RD
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City | CARLISLE
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State | PA
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Zip | 17015-9146
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Country | US
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Telephone | 717-697-4666
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MOUNT ALLEN DR
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City | MECHANICSBURG
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State | PA
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Zip | 17055-6171
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Country | US
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Telephone | 717-697-4666
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | TRACY BIESECKER
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Credential |
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Telephone | 717-591-7228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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