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Organization
HARBORCREEK YOUTH SERVICES
Active
Organization
HARBORCREEK YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN D. PETULLA LSW (CHIEF EXECUTIVE OFFICER)
(814) 899-7664
Entity
Organization
Contact information
Practice address
5712 IROQUOIS AVE, HASTINGS HOUSE, HARBORCREEK, PA 16421-1009
(814) 899-7664
Mailing address
5712 IROQUOIS AVE, HARBORCREEK, PA 16421-1009
(814) 899-7664
(814) 899-3075
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
405710
PA
Other
Enumeration date
04/03/2007
Last updated
08/22/2020
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