Organization
GANNONDALE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY ELAINE SABOL (EXECUTIVE DIRECTOR)
(814) 899-7659
Entity
Organization
Contact information
Practice address
4635 E LAKE RD, ERIE, PA 16511-1410
(814) 899-7659
Mailing address
4635 E LAKE RD, ERIE, PA 16511-1410
(814) 899-7659
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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