| Firetree, Ltd. | |
|
2275 Warren Road Indiana PA 15701-2444 | |
| (724) 471-1254 | |
| (724) 471-1249 |
| Full Name | Firetree, Ltd. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2275 Warren Road, Indiana, Pennsylvania |
| Authorized Official Name and Position | James Robert Desanto (PROJECT DIRECTOR) |
| Authorized Official Contact | 5706010877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Firetree, Ltd. 800 West Fourth Street Suite 202 Williamsport PA 17701-5895 Ph: (570) 601-0877 | Firetree, Ltd. 2275 Warren Road Indiana PA 15701-2444 Ph: (724) 471-1254 |
| NPI Number | 1780100453 |
|---|---|
| Provider Enumeration Date | 08/15/2017 |
| Last Update Date | 08/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780100453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 327030 (Pennsylvania) | Primary |
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