Organization
TIOGA COUNTY DEPT OF HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL GREENE (ADMINISTRATOR)
(570) 724-5766
Entity
Organization
Contact information
Practice address
179 MAIN ST, OSCEOLA, PA 16942
(800) 242-5766
(570) 662-7726
Mailing address
1873 SHUMWAY HILL RD, WELLSBORO, PA 16901-6840
(570) 724-5766
(570) 724-6757
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
597025
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000000400042
—
PA
Enumeration date
03/21/2007
Last updated
08/22/2020
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