Healthcare Provider Details

I. General information

NPI: 1467079319
Provider Name (Legal Business Name): ON-SITE COMPANIONSHIP SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2020
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 OBERLIN ST
PITTSBURGH PA
15206-1957
US

IV. Provider business mailing address

260 CRANDON BLVD STE 18
KEY BISCAYNE FL
33149-1537
US

V. Phone/Fax

Practice location:
  • Phone: 412-901-1341
  • Fax:
Mailing address:
  • Phone: 412-606-7095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: STEVEN CLYDE WILLIAMS JR.
Title or Position: CEO
Credential:
Phone: 412-606-7095