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Contact Information

CLEARFIELD-JEFFERSON MHMR PROGRAM
1200 WOOD ST STE U110
BROCKWAY, PA15824-2118
 Phone: 814-265-1060
 Fax: 814-265-1049
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Management

251B00000X
Indicates primary specialty

NPI Profile & details for CLEARFIELD-JEFFERSON MHMR PROGRAM

NPI Number 1407911225
LBN Legal business name CLEARFIELD-JEFFERSON MHMR PROGRAM
Authorized official COLETTE DUSHAC - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 12/22/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
PA Medicaid 1007332450001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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