Organization
PRINCE MARK'S PLACE
Active
Organization
PRINCE MARK'S PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE DYNKA (CEO)
(724) 337-6275
Entity
Organization
Contact information
Practice address
376 PINECREST DR, LOWER BURRELL, PA 15068-2330
(724) 337-6275
Mailing address
376 PINECREST DR, LOWER BURRELL, PA 15068-2330
(724) 337-6275
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
425900
PA
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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