Healthcare Provider Details

I. General information

NPI: 1487005609
Provider Name (Legal Business Name): INTERVENTION FUNDAMENTALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MURRAY AVE UNIT 81264
PITTSBURGH PA
15217-6620
US

IV. Provider business mailing address

1800 MURRAY AVE UNIT 81264
PITTSBURGH PA
15217-6620
US

V. Phone/Fax

Practice location:
  • Phone: 412-438-3268
  • Fax: 888-876-5473
Mailing address:
  • Phone: 412-438-3268
  • Fax: 888-876-5473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberBH002964
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberBH002964
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberBH002964
License Number StatePA

VIII. Authorized Official

Name: RANDALL KEECH
Title or Position: OWNER / CLINICAL DIRECTOR
Credential: MED, BCBA, LBS
Phone: 412-438-3268