Healthcare Provider Details

I. General information

NPI: 1356769517
Provider Name (Legal Business Name): WATSON INSTITUTE FRIENDSHIP ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 S NEGLEY AVE
PITTSBURGH PA
15206-3522
US

IV. Provider business mailing address

255 S NEGLEY AVE
PITTSBURGH PA
15206-3522
US

V. Phone/Fax

Practice location:
  • Phone: 412-365-3868
  • Fax: 412-361-6775
Mailing address:
  • Phone: 412-365-3868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberSW002438E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberSW002438E
License Number StatePA

VIII. Authorized Official

Name: MS. JEANNIE M STARZYNSKI
Title or Position: CLINICAL SOCIAL WORKER
Credential: LSW
Phone: 412-365-3868