Healthcare Provider Details

I. General information

NPI: 1457480758
Provider Name (Legal Business Name): COMMUNITY PSYCHIATRIC CENTERS OUTPATIENT CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 E PITTSBURGH ST
GREENSBURG PA
15601-3502
US

IV. Provider business mailing address

2 COLONIAL PL
PITTSBURGH PA
15232-1418
US

V. Phone/Fax

Practice location:
  • Phone: 724-850-7200
  • Fax: 724-850-7214
Mailing address:
  • Phone: 412-681-4530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number402720
License Number StatePA

VIII. Authorized Official

Name: DR. ROBERT A. LOWENSTEIN
Title or Position: GENERAL PARTNER
Credential: M.D.
Phone: 412-681-4530