Organization
CENTRE COUNTY MH ID EI DA
Active
Parent organization
COUNTY OF CENTRE
Other names
Targeted Case Management
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF CENTRE
Authorized official
THOMAS J MCDERMOTT (ADMINISTRATOR)
(814) 355-6782
Entity
Organization
Contact information
Practice address
3500 E COLLEGE AVE, SUITE 1200, STATE COLLEGE, PA 16801-7569
(814) 355-6782
(814) 355-6985
Mailing address
3500 E COLLEGE AVE, SUITE 1200, STATE COLLEGE, PA 16801-7569
(814) 355-6782
(814) 355-6985
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007296630022
—
PA
Enumeration date
04/30/2007
Last updated
08/07/2015
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