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General NPI Number Information
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NPI Number | 1023538527
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN PENNSYLVANIA AREA
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Dates
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Enumeration Date | 06/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 300 CHAMBER PLZ STE 305
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City | CHARLEROI
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State | PA
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Zip | 15022-1607
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Country | US
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Telephone | 724-489-8080
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Fax | 724-483-9360
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Provider Business Mailing Address
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Address Line | 300 CHAMBER PLZ STE 305
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City | CHARLEROI
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State | PA
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Zip | 15022-1607
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Country | US
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Telephone | 724-489-8080
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Fax | 724-483-9360
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LESLIE T GRENFELL
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Credential |
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Telephone | 724-489-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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