Provider Demographics
NPI:1730955873
Name:GRACE COMMUNITY CHURCH OF CRANBERRY TOWNSHIP PA
Entity type:Organization
Organization Name:GRACE COMMUNITY CHURCH OF CRANBERRY TOWNSHIP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-779-7997
Mailing Address - Street 1:9160 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-2912
Mailing Address - Country:US
Mailing Address - Phone:724-779-7997
Mailing Address - Fax:724-779-7996
Practice Address - Street 1:9160 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-2912
Practice Address - Country:US
Practice Address - Phone:724-779-7997
Practice Address - Fax:724-779-7996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty