Organization
GLADE RUN LUTHERAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES T. LOCKWOOD M.DIV. (EXECUTIVE DIRECTOR)
(724) 452-4453
Entity
Organization
Contact information
Practice address
70 BEAVER ROAD, ZELIENOPLE, PA 16063-0070
(724) 452-4453
(724) 452-6576
Mailing address
P.O. BOX 70, ZELIENOPLE, PA 16063-0070
(724) 452-4453
(724) 452-6576
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100754254-0022
—
PA
Enumeration date
01/30/2007
Last updated
08/22/2020
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