National Provider Identifier Database

GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA
Rehabilitation, Substance Use Disorder


Contact Information

GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA
233 GEORGE JUNIOR ROAD
GROVE CITY, PA16127
Phone: 724-458-9330
Fax:
Website:
Specialty Taxonomy Code
* Rehabilitation, Substance Use Disorder 261QR0405X

* Indicates primary specialty

NPI Profile & details for GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA

NPI Number 1669597795
Legal business name
LBN
GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA
Authorized official NATHAN GRESSEL - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 03/20/2007
Last updated 02/27/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • PA Medicaid: 0014522190133

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA

There are currently no reviews for GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA


NPIdb - Home
v2.201