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General NPI Number Information
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NPI Number | 1740528413
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Entity Type | Organization
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Legal Business Name | GOODWILL OF SOUTHWESTERN PENNSYLVANIA
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 118 52ND ST
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City | PITTSBURGH
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State | PA
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Zip | 15201-2593
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Country | US
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Telephone | 412-632-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 118 52ND ST
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City | PITTSBURGH
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State | PA
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Zip | 15201-2593
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Country | US
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Telephone | 412-632-1900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. MICHAEL J SMITH
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Credential |
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Telephone | 412-632-1902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 442660
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License Number State | PA
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