Blended Spirits Ranch
NPI #1538624879 in Fairview, Pennsylvania
Provider Information
- NPI Number
- 1538624879
- Entity Type
- Organization
- Organization Name
- Blended Spirits Ranch
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Jan 31, 2019
- Last Updated
- Jan 31, 2019
Practice Location
- Address
- 7401 MCCRAY RD
- City
- Fairview
- State
- Pennsylvania
- ZIP Code
- 16415-2401
- Phone
- (814) 449-5657
Authorized Official
- Name
- SANDRA LONG
- Title
- EXECUTIVE DIRECTOR
- Phone
- (814) 449-5657
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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