Organization
RIVER VALLEY HEALTH
Active
Organization
RIVER VALLEY HEALTH
Active
Other names
Susquehanna Community Health and Dental Clinic, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAX HOUSEKNECHT JR. (PRESENDENT/CEO)
(570) 567-5400
Entity
Organization
Contact information
Practice address
471 HEPBURN ST, WILLIAMSPORT, PA 17701-6122
(570) 567-5400
(570) 567-5421
Mailing address
471 HEPBURN ST, WILLIAMSPORT, PA 17701-6122
(570) 567-5400
(570) 567-5421
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024416060001
—
PA
05
—
1024416060002
—
PA
Enumeration date
03/06/2012
Last updated
02/12/2025
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