Organization
MARTHA LLOYD COMMUNITY RESIDENTIAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MILLER (CRF DIRECTOR)
(570) 297-2185
Entity
Organization
Contact information
Practice address
54 MOUNT ZION ROAD EXT, WELLSBORO, PA 16901-8706
(570) 297-2185
Mailing address
190 W MAIN ST, TROY, PA 16947-1131
(570) 297-2185
(570) 297-1019
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
216180
PA
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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