Organization
CONCERN-PROFESSIONAL SERVICES FOR CHILDREN, YOUTH & FAMILIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON H MAY (PRESIDENT/CEO)
(484) 578-9600
Entity
Organization
Contact information
Practice address
269 ROUTE 6 W RM 2, COUDERSPORT, PA 16915-8465
(570) 724-7142
Mailing address
1 W MAIN ST, FLEETWOOD, PA 19522-1323
(484) 578-9600
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100006375
—
PA
Enumeration date
10/04/2022
Last updated
05/25/2023
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