Organization
DIAKON CHILD,FAMILY&COMMUNITY MINISTRIES
Active
Parent organization
DIAKON LUTHERAN SOCIAL MINISTRIES
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIAKON LUTHERAN SOCIAL MINISTRIES
Authorized official
DEBORAH P WHITE (DIRECTOR OF ADMINISTRATIVE OPS)
(570) 322-7878
Entity
Organization
Contact information
Practice address
1801 LOYALSOCK DR, WILLIAMSPORT, PA 17701-2829
(570) 322-7873
(570) 322-8026
Mailing address
435 W 4TH ST, WILLIAMSPORT, PA 17701-6001
(570) 322-7873
(570) 322-8026
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102920256-0001
—
PA
Enumeration date
01/29/2018
Last updated
01/29/2018
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