Healthcare Provider Details

I. General information

NPI: 1770344483
Provider Name (Legal Business Name): THE CHILDREN'S INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 01/22/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 NORTHUMBERLAND STREET
PITTSBURGH PA
15217-1350
US

IV. Provider business mailing address

1405 SHADY AVE
PITTSBURGH PA
15217-1350
US

V. Phone/Fax

Practice location:
  • Phone: 412-420-2400
  • Fax:
Mailing address:
  • Phone: 412-420-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JOHN JUBAS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 412-420-2400