# MARCUS SELF DISCOVERY GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013532266
- **Authorized official:** MR. HARRY SHANE FALWELL (FOUNDER/CEO)
- **Authorized official phone:** (484) 840-6929

## Contact information

- **Practice address:** 2203 W LIBERTY ST, ALLENTOWN, PA 18104-4323
- **Practice address phone:** (484) 840-6929
- **Mailing address:** 2203 W LIBERTY ST, ALLENTOWN, PA 18104-4323
- **Mailing address phone:** (484) 840-6929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 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