Organization
COMMUNITY GUIDANCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRIN J MIKULA (CFO)
(724) 465-5576
Entity
Organization
Contact information
Practice address
200 PRUSHNOK DRIVE - LEVER STREET, SUITE 103, PUNXSUTAWNEY, PA 15767
(814) 938-4444
(814) 938-3313
Mailing address
793 OLD ROUTE 119 HIGHWAY NORTH, INDIANA, PA 15701
(724) 465-5576
(724) 465-6379
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
100003328
PA
251S00000X
Community/Behavioral Health Agency
421220
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000033280040
—
PA
Enumeration date
07/19/2007
Last updated
05/20/2014
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