Healthcare Provider Details

I. General information

NPI: 1053280883
Provider Name (Legal Business Name): ACADIA CRANBERRY CTC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SMITH DR
CRANBERRY TOWNSHIP PA
16066-4131
US

IV. Provider business mailing address

301 SMITH DR
CRANBERRY TOWNSHIP PA
16066-4131
US

V. Phone/Fax

Practice location:
  • Phone: 724-779-2010
  • Fax: 724-779-2011
Mailing address:
  • Phone: 724-779-2010
  • Fax: 724-779-2011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State

VIII. Authorized Official

Name: EVELYN DILLON
Title or Position: LPN
Credential:
Phone: 724-504-6979