Organization
NORTHUMBERLAND COUNTY MENTAL HEALTH MENTAL RETARDATION PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDITH C DAVIS (ADMINISTRATOR)
(570) 495-2002
Entity
Organization
Contact information
Practice address
217 N CENTER ST, BLDG A, SUNBURY, PA 17801-2205
(570) 495-2010
(570) 988-4991
Mailing address
217 N CENTER ST, BLDG A, SUNBURY, PA 17801-2205
(570) 495-2212
(570) 988-4444
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007378070019
—
PA
Enumeration date
12/05/2005
Last updated
08/22/2020
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