Healthcare Provider Details

I. General information

NPI: 1114598935
Provider Name (Legal Business Name): RR HEALTH SERVICES OF PA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2021
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2526 MONROEVILLE BLVD STE 102
MONROEVILLE PA
15146-2372
US

IV. Provider business mailing address

300 HANSEN PLZ
LYNDORA PA
16045-1610
US

V. Phone/Fax

Practice location:
  • Phone: 877-446-6331
  • Fax:
Mailing address:
  • Phone: 877-446-6331
  • Fax: 855-919-6051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: JESSICA ZAVILLA
Title or Position: REGIONAL MANAGER
Credential:
Phone: 877-446-6331