Organization
TIOGA COUNTY DEPT OF HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL GREENE (ADMINISTRATOR)
(570) 724-5766
Entity
Organization
Contact information
Practice address
ST. JAMES & THIRD ST., MANSFIELD, PA 16933
(570) 662-7600
(570) 662-7726
Mailing address
1873 SHUMWAY HILL RD, WELLSBORO, PA 16901-6840
(570) 724-5766
(570) 724-6757
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000000400025
—
PA
Enumeration date
03/21/2007
Last updated
06/21/2010
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