Healthcare Provider Details

I. General information

NPI: 1982803037
Provider Name (Legal Business Name): MON YOUGH COMMUNITY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 LOCUST ST
MCKEESPORT PA
15132-2911
US

IV. Provider business mailing address

500 WALNUT ST 3RD FL
MCKEESPORT PA
15132-2801
US

V. Phone/Fax

Practice location:
  • Phone: 412-675-8533
  • Fax: 412-675-8920
Mailing address:
  • Phone: 412-675-8533
  • Fax: 412-675-8920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CATHERINE CONROY
Title or Position: MANAGED CARE COORDINATOR
Credential:
Phone: 412-675-8533