Healthcare Provider Details

I. General information

NPI: 1952936874
Provider Name (Legal Business Name): THE CHILDREN'S HOME OF PITTSBURGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2020
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5324 PENN AVE 2ND FLOOR, STE 250
PITTSBURGH PA
15224-1733
US

IV. Provider business mailing address

5324 PENN AVE
PITTSBURGH PA
15224-1733
US

V. Phone/Fax

Practice location:
  • Phone: 412-441-4884
  • Fax: 412-441-0167
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY A PHILLIPS
Title or Position: CFO
Credential:
Phone: 412-441-4884