Organization
TIOGA COUNTY DEPT. OF HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAX HARRISON (ADMINISTRATOR)
(570) 724-5766
Entity
Organization
Contact information
Practice address
63 THIRD STREET, SUITE 103, MANSFIELD, PA 16933
(570) 662-7600
(570) 662-7726
Mailing address
1873 SHUMWAY HILL ROAD, WELLSBORO, PA 16901
(570) 724-5766
(570) 724-6757
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
228510
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000000400025
—
PA
Enumeration date
08/02/2006
Last updated
03/25/2011
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