Healthcare Provider Details

I. General information

NPI: 1811018898
Provider Name (Legal Business Name): PYRAMID HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3893 WEST MAIN STREET
BELLEVILLE PA
17004-9252
US

IV. Provider business mailing address

1894 OLD ROUTE 220 N P.O. BOX 967
DUNCANSVILLE PA
16635-8304
US

V. Phone/Fax

Practice location:
  • Phone: 717-935-5400
  • Fax: 717-935-5413
Mailing address:
  • Phone: 814-940-0407
  • Fax: 814-941-0574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number447027
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number447027
License Number StatePA

VIII. Authorized Official

Name: MR. JASON HENDRICKS
Title or Position: CEO
Credential:
Phone: 814-940-0407