Organization
EXPERIENCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FARLEY WRIGHT (EXECUTIVE DIRECTOR)
(814) 723-3763
Entity
Organization
Contact information
Practice address
905 4TH AVE, WARREN, PA 16365-1802
(814) 723-3763
(814) 723-3271
Mailing address
PO BOX 886, WARREN, PA 16365-0886
(814) 723-3763
(814) 723-3271
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018423210001
—
PA
Enumeration date
07/24/2012
Last updated
07/24/2012
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