Provider Demographics
NPI:1528295045
Name:RAYSTOWN DEVELOPMENTAL SERVICES, INC
Entity type:Organization
Organization Name:RAYSTOWN DEVELOPMENTAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-643-6510
Mailing Address - Street 1:306 PENN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-1446
Mailing Address - Country:US
Mailing Address - Phone:814-643-6510
Mailing Address - Fax:814-643-0879
Practice Address - Street 1:306 PENN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-1446
Practice Address - Country:US
Practice Address - Phone:814-643-6510
Practice Address - Fax:814-643-0879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities