Provider Demographics
NPI:1326205170
Name:PENNSYLVANIA ASSESSMENT CONSULTANTS FOR CO OCCURRING DISORDERS LLC
Entity type:Organization
Organization Name:PENNSYLVANIA ASSESSMENT CONSULTANTS FOR CO OCCURRING DISORDERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:LEONARDO
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CAC
Authorized Official - Phone:610-262-6999
Mailing Address - Street 1:2030 CENTER ST. PLAZA
Mailing Address - Street 2:SUITE 104,
Mailing Address - City:NORTHAMPTON, PA 18067
Mailing Address - State:PA
Mailing Address - Zip Code:18067
Mailing Address - Country:US
Mailing Address - Phone:610-262-6999
Mailing Address - Fax:610-262-6990
Practice Address - Street 1:2030 CENTER ST. PLAZA
Practice Address - Street 2:SUITE 104,
Practice Address - City:NORTHAMPTON, PA 18067
Practice Address - State:PA
Practice Address - Zip Code:18067
Practice Address - Country:US
Practice Address - Phone:610-262-6999
Practice Address - Fax:610-262-6990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty