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General NPI Number Information
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NPI Number | 1780218594
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Entity Type | Organization
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Legal Business Name | DAVIS ARCHWAY CENTERS FOR ADDICTION TREATMENT, INC.
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 114 COURSON LN
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City | EMLENTON
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State | PA
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Zip | 16373-2502
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Country | US
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Telephone | 724-867-0202
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Fax | 724-867-0270
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Provider Business Mailing Address
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Address Line | 114 COURSON LN
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City | EMLENTON
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State | PA
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Zip | 16373-2502
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Country | US
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Telephone | 724-867-0202
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Fax | 724-867-0202
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Authorized Official
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Title or Position | CEO
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Name | MR. CHET LEECH
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Credential | MS
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Telephone | 724-867-0202
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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