# KETTLE CREEK OUTFITTERS LTD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KETTLE CREEK OUTFITTERS LTD
- **Other names:** Need a place to Go
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1700408390
- **Legal business name:** KETTLE CREEK OUTFITTERS LTD
- **Authorized official:** DAVID RALPH FLACK (OWNER)
- **Authorized official phone:** (570) 502-2919

## Contact information

- **Practice address:** 88 QUIET OAKS CAMPGROUND LN, CROSS FORK, PA 17729-9430
- **Practice address phone:** (570) 502-2919
- **Practice address fax:** (570) 923-1799
- **Mailing address:** 88 QUIET OAKS CAMPGROUND LN, CROSS FORK, PA 17729-9430
- **Mailing address phone:** (570) 502-2919
- **Mailing address fax:** (570) 923-1799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/18/2020
- **Last updated:** 05/18/2020