Organization
DAYSTAR CENTER FOR SPIRITUAL RECOVERY
Active
Organization
DAYSTAR CENTER FOR SPIRITUAL RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FERN ROBERTA WILCOX LPC, CAADC (EXECUTIVE DIRECTOR)
(717) 230-9898
Entity
Organization
Contact information
Practice address
125 N. 18TH ST., HARRISBURG, PA 17103
(717) 230-9898
(717) 238-1793
Mailing address
PO BOX 60574, HARRISBURG, PA 17106
(717) 230-9898
(717) 238-1793
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
227077
PA
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018539150001
—
PA
01
—
100035
CCBH IDENTIFIER
PA
01
—
227077
DEPT OF HEALTH FACILITY
PA
Enumeration date
03/08/2007
Last updated
06/09/2015
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