Organization
CMSU BH/DS
Active
Organization
CMSU BH/DS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD D. BEACH LCSW, BCD (ADMINISTRATOR)
(570) 275-5422
Entity
Organization
Contact information
Practice address
100 TERRACE LN, DANVILLE, PA 17821-2142
(570) 275-5422
(570) 275-6610
Mailing address
PO BOX 219, DANVILLE, PA 17821-0219
(570) 275-5422
(570) 275-6610
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100002090
CCRI
PA
Enumeration date
05/04/2016
Last updated
05/04/2016
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