Healthcare Provider Details

I. General information

NPI: 1780235929
Provider Name (Legal Business Name): WADDINGTON REHAB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2019
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2681 WADDINGTON AVE
PITTSBURGH PA
15226-1758
US

IV. Provider business mailing address

100 STOOPS DR STE 240
MONONGAHELA PA
15063-3553
US

V. Phone/Fax

Practice location:
  • Phone: 412-207-2186
  • Fax:
Mailing address:
  • Phone: 724-483-4282
  • Fax: 724-483-4078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ARIF RAFI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 724-483-4282