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Organization
MARCUS SELF DISCOVERY GROUP LLC
Active
Organization
MARCUS SELF DISCOVERY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRY SHANE FALWELL (FOUNDER/CEO)
(484) 840-6929
Entity
Organization
Contact information
Practice address
2203 W LIBERTY ST, ALLENTOWN, PA 18104-4323
(484) 840-6929
Mailing address
2203 W LIBERTY ST, ALLENTOWN, PA 18104-4323
(484) 840-6929
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
177F00000X
Lodging Provider
—
NULL
251B00000X
Case Management Agency
—
NULL
251V00000X
Voluntary or Charitable Agency
—
NULL
252Y00000X
Early Intervention Provider Agency
—
NULL
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
NULL
347C00000X
Private Vehicle
—
NULL
Other
Enumeration date
06/13/2020
Last updated
06/13/2020
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