Organization
CHILDREN'S CENTER FOR TREATMENT AND EDUCATION
Active
Other names
Beacon Light Behavioral Health System
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN TECONCHUK (ASSOCIATE DIRECTOR OF OPERATIONS)
(814) 817-1400
Entity
Organization
Contact information
Practice address
945 SOUTH AVE, CUSTER CITY, PA 16725
(814) 817-1400
Mailing address
800 E MAIN ST, BRADFORD, PA 16701-3278
(814) 817-1400
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100771021
—
PA
Enumeration date
10/14/2020
Last updated
10/14/2020
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