Organization
WAGNER BEHAVIORAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL KEARNEY (MEDICAL BILLING SPECIALIST)
(814) 580-1743
Entity
Organization
Contact information
Practice address
1001 STATE ST STE 102, ERIE, PA 16501-1835
(814) 580-1743
(814) 240-6347
Mailing address
1001 STATE ST STE 102, ERIE, PA 16501-1835
(814) 580-1743
(814) 240-6347
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CW015648
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102243824
—
PA
Enumeration date
02/17/2011
Last updated
07/26/2019
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