Healthcare Provider Details

I. General information

NPI: 1205969508
Provider Name (Legal Business Name): PRESSLEY RIDGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 CHAMBERS CIRCLE RD
WALKER WV
26180
US

IV. Provider business mailing address

530 MARSHALL AVE
PITTSBURGH PA
15214-3016
US

V. Phone/Fax

Practice location:
  • Phone: 304-679-3728
  • Fax: 304-673-3058
Mailing address:
  • Phone: 412-321-6995
  • Fax: 412-321-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BETH BLAIR
Title or Position: SR ACCOUNTING DIRECTOR
Credential:
Phone: 412-321-6995