Provider Demographics
NPI:1962602318
Name:KEELING HEALTH CENTER
Entity type:Organization
Organization Name:KEELING HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNAK
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:814-393-2121
Mailing Address - Street 1:840 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-1240
Mailing Address - Country:US
Mailing Address - Phone:814-393-2121
Mailing Address - Fax:814-393-2035
Practice Address - Street 1:840 WOOD ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1240
Practice Address - Country:US
Practice Address - Phone:814-393-2121
Practice Address - Fax:814-393-2035
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLARION UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health