Organization
COMMUNITY CARE & ADDICTION RECOVERY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL MWANGI (OWNER/CEO)
(717) 696-5442
Entity
Organization
Contact information
Practice address
141 E MAIN ST, LEOLA, PA 17540-1916
(717) 696-5442
(717) 656-7330
Mailing address
342 CAROL LYNN DR, WILLOW STREET, PA 17584-9366
(717) 696-5442
(717) 656-7330
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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