# PENN RESIDENTIAL, INC.

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

## Provider details

- **NPI number:** 1689911554
- **Authorized official:** CLYDE WILLIAMS (C.E.O.)
- **Authorized official phone:** (724) 635-0048

## Contact information

- **Practice address:** PO BOX C, NEW STANTON, PA 15672-0417
- **Practice address phone:** (724) 635-0048
- **Practice address fax:** (724) 635-0746
- **Mailing address:** PO BOX C, NEW STANTON, PA 15672-0417
- **Mailing address phone:** (724) 635-0048
- **Mailing address fax:** (724) 635-0746

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 444280 | PA | Yes |

## Other

- **Enumeration date:** 01/11/2013
- **Last updated:** 01/11/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 102577794 | — | PA |