Organization
SAGEWOOD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA GRACE FASS MS (PRESIDENT)
(814) 362-5579
Entity
Organization
Contact information
Practice address
63 N MAIN ST, PORT ALLEGANY, PA 16743-1369
(814) 598-1101
Mailing address
PO BOX 370, BRADFORD, PA 16701-0370
(814) 362-5579
(814) 368-5997
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/12/2020
Last updated
06/12/2020
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