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General NPI Number Information
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NPI Number | 1417091331
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Entity Type | Organization
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Legal Business Name | ALPHA HOUSE, INC
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 435 SHADY AVE
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City | PITTSBURGH
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State | PA
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Zip | 15206
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Country | US
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Telephone | 412-363-4220
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Fax | 412-363-6570
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Provider Business Mailing Address
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Address Line | 435 SHADY AVE
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City | PITTSBURGH
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State | PA
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Zip | 15206
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Country | US
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Telephone | 412-363-4220
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Fax | 412-363-6570
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JORDAN COUGHLEN
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Credential | MPH, MSW
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Telephone | 412-363-4220
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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 | 740086
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License Number State | PA
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