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General NPI Number Information
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NPI Number | 1588793145
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Entity Type | Organization
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Legal Business Name | THE SALVATION ARMY
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 08/15/2017
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Provider Practice Location Address
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Address Line | 865 W NORTH AVE
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City | PITTSBURGH
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State | PA
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Zip | 15233-1616
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Country | US
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Telephone | 412-231-0500
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Fax | 412-231-7809
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Provider Business Mailing Address
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Address Line | 440 WEST NYACK ROAD PO BOX C-635
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City | WEST NYACK
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State | NY
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Zip | 10994-1739
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Country | US
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Telephone | 845-620-7200
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Fax | 845-620-7615
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. MICHAEL JOHN SOUTHWICK
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Credential |
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Telephone | 845-620-7329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 770450
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License Number State | PA
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