# TIOGA COUNTY DEPT OF HUMAN SERVICES

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

## Provider details

- **NPI number:** 1558486571
- **Authorized official:** MR. SAMUEL GREENE (ADMINISTRATOR)
- **Authorized official phone:** (570) 724-5766

## Contact information

- **Practice address:** 1873 SHUMWAY HILL RD, WELLSBORO, PA 16901-6840
- **Practice address phone:** (570) 724-5766
- **Practice address fax:** (570) 724-6757
- **Mailing address:** 1873 SHUMWAY HILL RD, WELLSBORO, PA 16901-6840
- **Mailing address phone:** (570) 724-5766
- **Mailing address fax:** (570) 724-6757

## Taxonomy

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

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1000000400036 | — | PA |