Healthcare Provider Details

I. General information

NPI: 1992065056
Provider Name (Legal Business Name): PASSAVANT MEMORIAL HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 THORN HILL RD
WARRENDALE PA
15086-7527
US

IV. Provider business mailing address

163 THORN HILL RD
WARRENDALE PA
15086-7527
US

V. Phone/Fax

Practice location:
  • Phone: 412-585-1667
  • Fax:
Mailing address:
  • Phone: 412-585-1667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ASHLEY LYNN-MARIE SENFT
Title or Position: DIRECTOR OF SOCIAL SERVICES
Credential: LSW
Phone: 412-585-1667