Organization
CLINICAL OUTCOMES GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA FLEISCHUT MA (FACILITY DIRECTOR)
(570) 628-6990
Entity
Organization
Contact information
Practice address
1 S 2ND ST FL 1, POTTSVILLE, PA 17901-3088
(570) 628-6990
(570) 628-5899
Mailing address
1 S 2ND ST FL 1, POTTSVILLE, PA 17901-3088
(570) 628-6990
(570) 628-5899
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW125918
PA
261Q00000X
Clinic/Center
Primary
PC000151
PA
291U00000X
Clinical Medical Laboratory
PC000151
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101365368
—
PA
Enumeration date
02/22/2008
Last updated
06/26/2020
Update your record
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