Provider Demographics
NPI:1154541837
Name:THE CLINIC FOR SPECIAL CHILDREN, INC.
Entity type:Organization
Organization Name:THE CLINIC FOR SPECIAL CHILDREN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:HEAPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-687-9407
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:INTERCOURSE
Mailing Address - State:PA
Mailing Address - Zip Code:17534-9998
Mailing Address - Country:US
Mailing Address - Phone:717-687-9407
Mailing Address - Fax:717-687-9237
Practice Address - Street 1:20 COMMUNITY LANE
Practice Address - Street 2:
Practice Address - City:GORDONVILLE
Practice Address - State:PA
Practice Address - Zip Code:17529
Practice Address - Country:US
Practice Address - Phone:717-687-9407
Practice Address - Fax:717-687-9237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 208000000X, 363LP0222X
PA39D0662473261QG0250X
PA021547261QG0250X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGeneticsGroup - Multi-Specialty
No363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical CareGroup - Multi-Specialty