Organization
PA CARE, LLC
Active
Other names
State College Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN TANIS (EXECUTIVE DIRECTOR OF CONTRACT MGMT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
3091 ENTERPRISE DR, STATE COLLEGE, PA 16801-3099
(814) 235-6988
(814) 235-6989
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 439-6111
(814) 235-6989
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
10/21/2010
Last updated
12/23/2019
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