Organization
BETHESDA FAMILY SERVICES FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINIC P. HERBST M.A, M.S. (FOUNDER, PRESIDENT)
(570) 523-0605
Entity
Organization
Contact information
Practice address
1807 S MAIN ST, SAPULPA, OK 74066-6531
(918) 224-6349
(918) 224-7951
Mailing address
260 REITZ BLVD STE 6, LEWISBURG, PA 17837-9220
(570) 523-0605
(570) 523-0676
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
05/13/2010
Last updated
01/13/2017
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