Healthcare Provider Details

I. General information

NPI: 1942358510
Provider Name (Legal Business Name): TURTLE CREEK VALLEY MENTAL HEALTH MENTAL RETARDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 PENN AVE SUITE 302
TURTLE CREEK PA
15145-2082
US

IV. Provider business mailing address

519 PENN AVE SUITE 302
TURTLE CREEK PA
15145-2082
US

V. Phone/Fax

Practice location:
  • Phone: 412-225-6628
  • Fax:
Mailing address:
  • Phone: 412-225-6628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. FRANCINE MARTIN-SAMBUCO
Title or Position: FAMILY & ADOLESCENT OUTPATIENT THER
Credential: MSCAC
Phone: 412-225-6628