Organization
CONCERN-PROFESSIONAL SERVICES FOR CHILDREN, YOUTH & FAMILIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON H. MAY (EXECUTIVE DIRECTOR)
(610) 944-0445
Entity
Organization
Contact information
Practice address
1 DORSETT DR, MANSFIELD, PA 16933-1517
(570) 724-7142
Mailing address
1 W MAIN ST, FLEETWOOD, PA 19522-1323
(610) 944-0445
(610) 944-8834
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
221310
PA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
222440
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002717847
HIGHMARK BLUE SHIELD
PA
01
—
02328700
CAPITAL BLUE CROSS
PA
05
—
1000063750051
—
PA
Enumeration date
06/23/2013
Last updated
02/24/2017
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