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Organization
CLEARFIELD-JEFFERSON CMHC
Active
Organization
CLEARFIELD-JEFFERSON CMHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN H FORSHA B.S. EDUCATION (BILLING SUPERVISOR)
(814) 371-1100
Entity
Organization
Contact information
Practice address
103 N GILPIN ST, PUNXSUTAWNEY, PA 15767-2055
(814) 371-1100
(814) 375-0120
Mailing address
103 N GILPIN ST, PUNXSUTAWNEY, PA 15767-2055
(814) 371-1100
(814) 375-0120
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
436040
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007627390042
—
PA
01
—
124074
HIMARK
PA
Enumeration date
04/03/2007
Last updated
08/22/2020
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