Organization
ACHIEVEMENT CENTER OF LECOM HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE RICHARDS (SUPERVISOR OR CLIENT BILLING)
(814) 616-0509
Entity
Organization
Contact information
Practice address
4950 W 23RD ST, SUITE 1, ERIE, PA 16506
(814) 459-2755
(814) 456-4873
Mailing address
4950 W 23RD ST STE 1, ERIE, PA 16506-5802
(814) 459-2755
(814) 456-4873
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
PA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/19/2006
Last updated
09/29/2020
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