Organization
PEERSTAR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY J NULTON PHD (CEO)
(814) 262-0025
Entity
Organization
Contact information
Practice address
214 COLLEGE PARK PLAZA, JOHNSTOWN, PA 15904
(814) 262-0025
(814) 266-1548
Mailing address
214 COLLEGE PARK PLAZA, JOHNSTOWN, PA 15904
(814) 262-0025
(814) 266-1548
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
327880
PA
251S00000X
Community/Behavioral Health Agency
Primary
327920
PA
251S00000X
Community/Behavioral Health Agency
442490
PA
251S00000X
Community/Behavioral Health Agency
442510
PA
Other
Enumeration date
05/06/2010
Last updated
12/09/2010
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