# HERMITAGE HOUSE YOUTH SERVICES, INC

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

## Provider details

- **NPI number:** 1043859663
- **Authorized official:** MICHAEL ICKES (DIRECTOR OF FINANCE)
- **Authorized official phone:** (814) 734-4951

## Contact information

- **Practice address:** 25493 STATE HIGHWAY 99, CAMBRIDGE SPRINGS, PA 16403-2329
- **Practice address phone:** (814) 734-4951
- **Mailing address:** 25493 STATE HIGHWAY 99, CAMBRIDGE SPRINGS, PA 16403-2329
- **Mailing address phone:** (814) 734-4951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 12/30/2019
- **Last updated:** 12/30/2019