Healthcare Provider Details
I. General information
NPI: 1699004994
Provider Name (Legal Business Name): SOUTH WESTERN ALPHA HOUSING AND HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2009
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
745 GREENVILLE ROAD
MERCER PA
16137-5023
US
IV. Provider business mailing address
200 LOTHROP ST STE 10097
PITTSBURGH PA
15213-2536
US
V. Phone/Fax
- Phone: 724-662-5400
- Fax: 724-662-2043
- Phone: 412-864-3532
- Fax: 412-864-3554
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1024048900001 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
VIII. Authorized Official
Name:
WILLIAM
ANTHONY
NIGRO
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA
Phone: 412-864-3532