Healthcare Provider Details

I. General information

NPI: 1689853103
Provider Name (Legal Business Name): THREE RIVERS ADOPTION COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 07/03/2020
Certification Date: 07/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W CARSON ST
PITTSBURGH PA
15219-1031
US

IV. Provider business mailing address

1600 W CARSON ST
PITTSBURGH PA
15219-1031
US

V. Phone/Fax

Practice location:
  • Phone: 412-471-8722
  • Fax: 412-471-4861
Mailing address:
  • Phone: 412-471-8722
  • Fax: 412-471-4861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JACQUELINE D WILSON
Title or Position: EXECUTIVE DIRECTOR
Credential: LSW
Phone: 412-471-8722