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NPI 1609910769

NPI 1609910769 : TURTLE CREEK VALLEY MENTAL HEALTH MENTAL RETARDATION INC : HOMESTEAD, PA

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General NPI Number Information
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    NPI Number           |    1609910769
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    Entity Type          |    Organization 
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    Legal Business Name  |    TURTLE CREEK VALLEY MENTAL HEALTH MENTAL RETARDATION INC 
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Dates
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    Enumeration Date     |    02/20/2007
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    Last Update Date     |    08/17/2009
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Provider Practice Location Address
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    Address Line         |    1800 WEST ST 
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    City                 |    HOMESTEAD
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    State                |    PA
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    Zip                  |    15120-2578
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    Country              |    US
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    Telephone            |    412-462-9901
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    Fax                  |    412-462-4901
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Provider Business Mailing Address
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    Address Line         |    723 BRADDOCK AVE 
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    City                 |    BRADDOCK
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    State                |    PA
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    Zip                  |    15104-1849
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    Country              |    US
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    Telephone            |    412-351-0222
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    Fax                  |    412-351-2616
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Authorized Official
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    Title or Position    |    EXECUTIVE DIRECTOR
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    Name                 |     FRANCES  SHEEDY BOST 
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    Credential           |    
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    Telephone            |    412-351-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    422510
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    422510
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    License Number State |    PA
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