Organization
TIOGA COUNTY DEPT OF HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL GREENE (ADMINISTRATOR)
57072455766
Entity
Organization
Contact information
Practice address
1873 SHUMWAY HILL RD, WELLSBORO, PA 16901-6840
(570) 724-5766
(570) 724-6757
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
—
1000000400023
—
PA
Enumeration date
03/21/2007
Last updated
08/22/2020
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