Organization Name: | COMMUNITY COUNSELING CENTER OF MERCER COUNTY |
NPI Number: | 1023070729 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANGELO STAMOOLIS (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 2201 E State St Hermitage |
State: | PA US |
Postal Code: | 161482727 |
Phone Number: | 7249817141 |
Fax Number: | 7249817148 |
NPI Enumeration Date: | 04/06/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 402750 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |