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General NPI Number Information
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NPI Number | 1902889876
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Entity Type | Organization
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Legal Business Name | PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 1601 MAYVIEW RD
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City | BRIDGEVILLE
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State | PA
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Zip | 15017-1547
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Country | US
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Telephone | 412-257-6226
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Fax | 412-257-6808
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Provider Business Mailing Address
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Address Line | 1601 MAYVIEW RD
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City | BRIDGEVILLE
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State | PA
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Zip | 15017-1547
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Country | US
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Telephone | 412-257-6226
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Fax | 412-257-6808
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Authorized Official
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Title or Position | CEO
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Name | LINDA WYLIE
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Credential |
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Telephone | 412-257-6226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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