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General NPI Number Information
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NPI Number | 1235477159
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Entity Type | Organization
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Legal Business Name | LIGHT OF LIFE MINISTRIES, INC.
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Dates
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Enumeration Date | 01/28/2013
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | 913 WESTERN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15233-1717
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Country | US
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Telephone | 412-258-6147
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Fax |
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Provider Business Mailing Address
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Address Line | 913 WESTERN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15233-1717
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Country | US
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Telephone | 412-258-6147
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATION
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Name | DR. LEO SALGADO
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Credential | PH.D.
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Telephone | 412-258-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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