=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760365324
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEAVER VALLEY IU 27
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2025
-----------------------------------------------------
Last Update Date | 07/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 147 POPLAR AVE
-----------------------------------------------------
City | MONACA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15061-2585
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-774-7800
-----------------------------------------------------
Fax | 724-774-4751
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 147 POPLAR AVE
-----------------------------------------------------
City | MONACA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15061-2585
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-774-7800
-----------------------------------------------------
Fax | 724-774-4751
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACCESS COORDINATOR
-----------------------------------------------------
Name | KIMBERLY A BISKUP
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 412-685-7831
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------