Healthcare Provider Details

I. General information

NPI: 1043399124
Provider Name (Legal Business Name): SOUTHWOOD PSYCHIATRIC HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 STATION ST
BRIDGEVILLE PA
15017-1843
US

IV. Provider business mailing address

2575 BOYCE PLAZA RD
PITTSBURGH PA
15241-3925
US

V. Phone/Fax

Practice location:
  • Phone: 412-257-2290
  • Fax: 412-257-7689
Mailing address:
  • Phone: 412-257-2290
  • Fax: 412-257-7689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number402890
License Number StatePA

VIII. Authorized Official

Name: MR. BRIAN P FARLEY
Title or Position: VICE PRESIDENT & SECRETARY
Credential:
Phone: 615-861-6000