Healthcare Provider Details

I. General information

NPI: 1154674760
Provider Name (Legal Business Name): WESTMORELAND WEIGHT LOSS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 COMPASS CIR
GREENSBURG PA
15601-2786
US

IV. Provider business mailing address

1037 COMPASS CIR
GREENSBURG PA
15601-2786
US

V. Phone/Fax

Practice location:
  • Phone: 724-834-1144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER RICCIARDELLI
Title or Position: FACILITY DIRECTOR
Credential: MBA
Phone: 724-834-1144