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Organization

COMMUNITY COUNSELING CENTER OF MERCER COUNTY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELO STAMOOLIS M ED (CHIEF EXECUTIVE OFFICER)
(724) 981-7141
Entity
Organization

Contact information

Practice address
2201 E STATE ST, HERMITAGE, PA 16148-2727
(724) 981-7141
(724) 981-7763
Mailing address
2201 E STATE ST, HERMITAGE, PA 16148-2727
(724) 981-7141
(724) 981-7763

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
436150
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100000380
PA
Enumeration date
06/25/2008
Last updated
06/25/2008
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