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General NPI Number Information
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NPI Number | 1679730592
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH ASSOCIATION
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 225 SPRING ST
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City | BENTLEYVILLE
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State | PA
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Zip | 15314-1252
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Country | US
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Telephone | 724-239-3993
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Fax | 724-239-3997
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Provider Business Mailing Address
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Address Line | 15 S COLLEGE ST
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City | WASHINGTON
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State | PA
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Zip | 15301-4821
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Country | US
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Telephone | 724-225-2061
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Fax | 724-225-4770
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Authorized Official
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Title or Position | FISCAL TECHNICIAN
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Name | ALICE M SIMMS
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Credential |
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Telephone | 724-225-2061
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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 | 424660
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License Number State | PA
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