MEDICARE: UNIVERSAL COMMUNITY BEHAVIORAL HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	323060	PA

General Provider Information

NPI Number	:	1588932545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL COMMUNITY BEHAVIORAL HEALTH INC

Provider Business Mailing Address
First Line	:	132 THE MEADOWS DR
Second Line	:
City	:	CENTRE HALL
State	:	PA
Zip	:	16828-9231
Country	:	US
Telephone Number	:	814-364-2161
Fax Number	:

Provider Business Practice Location Address
First Line	:	241 BROAD ST
Second Line	:
City	:	MONTOURSVILLE
State	:	PA
Zip	:	17754-2283
Country	:	US
Telephone Number	:	814-364-2161
Fax Number	:

Authorized Official
Title or Position	:	SR VP CFO
Name	:	STEVE FILTON
Credential	:
Telephone Number	:	610-768-3300

Provider Enumeration Date	:	12/06/2011
Last Update Date	:	12/06/2011

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