| Organization Name: | JAN DAVIS-MARS HOME FOR YOUTH |
| NPI Number: | 1376664250 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVEN T GREEN (DIRECTOR OF DEVELOPMENT) |
| Mailing Address: | 521 Route 228 Mars |
| State: | PA US |
| Postal Code: | 160463123 |
| Phone Number: | 7246253141 |
| Fax Number: | |
| NPI Enumeration Date: | 04/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC002428 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |