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General NPI Number Information
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NPI Number | 1659216265
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Entity Type | Organization
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Legal Business Name | DTAC OF CRANBERRY LLC
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 9528 GOEHRING ROAD
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City | CRANBERRY TOWNSHIP
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State | PA
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Zip | 16066
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Country | US
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Telephone | 724-513-4312
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Fax |
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Provider Business Mailing Address
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Address Line | 411 OLD BALTIMORE PIKE
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City | CHADDS FORD
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State | PA
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Zip | 19317-9485
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF BUSINESS OFFICER
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Name | JESSICA LYLES
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Credential | MBA
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Telephone | 561-871-9569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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