Organization
CLARION CO MH MR DRUG & ALCOHOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EVAN R DITTMAN (MH MR DRUG & ALCOHOL ADMINISTRATOR)
(814) 226-6252
Entity
Organization
Contact information
Practice address
214 S 7TH AVE, CLARION, PA 16214-2053
(814) 226-6252
(814) 226-8564
Mailing address
214 S 7TH AVE, CLARION, PA 16214-2053
(814) 226-6252
(814) 226-8564
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000073900005
—
PA
05
—
1000073900006
—
PA
05
—
1000073900008
—
PA
05
—
1000073900009
—
PA
05
—
1000073900014
—
PA
05
—
1000073900016
—
PA
05
—
1000073900017
—
PA
05
—
1000073900019
—
PA
05
—
1000073900020
—
PA
05
—
100007390025
—
PA
01
—
4634563
AETNA INSURANCE
PA
01
—
660501
HIGHMARK BC/BS
PA
Enumeration date
07/04/2006
Last updated
09/11/2025
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