MEDICARE: CRAY YOUTH AND FAMILY SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1477601169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAY YOUTH AND FAMILY SERVICES, INC

Provider Business Mailing Address
First Line	:	332 HIGHLAND AVE
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-3624
Country	:	US
Telephone Number	:	724-654-5507
Fax Number	:	724-654-5546

Provider Business Practice Location Address
First Line	:	332 HIGHLAND AVE
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-3624
Country	:	US
Telephone Number	:	724-654-5507
Fax Number	:	724-654-5546

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. DAVID COPPER
Credential	:	M.ED
Telephone Number	:	724-654-5507

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	08/22/2020

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