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General NPI Number Information
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NPI Number | 1104040302
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Entity Type | Organization
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Legal Business Name | LAUREL HIGHLANDS FOUNDATION, INC.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1217 MOUNT PLEASANT RD
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City | GREENSBURG
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State | PA
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Zip | 15601-6331
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Country | US
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Telephone | 724-838-8149
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Fax | 724-838-8149
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Provider Business Mailing Address
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Address Line | 1000 JACKS RUN RD
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City | NORTH VERSAILLES
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State | PA
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Zip | 15137-2744
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Country | US
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Telephone | 412-825-9141
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Fax | 412-825-9456
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. TIMOTHY W. PEARL
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Credential |
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Telephone | 412-825-9141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 436000
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License Number State | PA
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