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General NPI Number Information
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NPI Number | 1710031836
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Entity Type | Organization
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Legal Business Name | MEADVILLE MEDICAL CENTER
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 1034 GROVE ST INPATIENT DRUG AND ALCOHOL
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City | MEADVILLE
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State | PA
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Zip | 16335-2945
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Country | US
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Telephone | 814-333-5810
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Fax | 814-333-5817
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Provider Business Mailing Address
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Address Line | 1034 GROVE ST
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City | MEADVILLE
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State | PA
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Zip | 16335-2945
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Country | US
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Telephone | 814-333-5000
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Fax | 814-333-5640
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | RENATO J SUNTAY
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Credential |
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Telephone | 814-333-5031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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