Organization
DIAKON CHILD FAMILY & COMMUNITY MINISTRIES
Active
Other names
Family Life Services
Organization subpart
No
Provider details
NPI number
Authorized official
RITA ROUSSEAU (EXECUTIVE DIRECTOR)
(717) 795-0330
Entity
Organization
Contact information
Practice address
25 E MCCLURE ST, NEW BLOOMFIELD, PA 17068-9334
(717) 795-0330
Mailing address
25 E MCCLURE ST, NEW BLOOMFIELD, PA 17068-9334
(717) 795-0330
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
507058
LICENSE NUMBER
PA
Enumeration date
01/14/2015
Last updated
01/14/2015
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