MEDICARE: THE PREVENTION NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	047050	PA

General Provider Information

NPI Number	:	1578751475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PREVENTION NETWORK

Provider Business Mailing Address
First Line	:	270 OHIO RIVER BLVD
Second Line	:
City	:	BADEN
State	:	PA
Zip	:	15005-1914
Country	:	US
Telephone Number	:	724-869-2222
Fax Number	:	724-869-3155

Provider Business Practice Location Address
First Line	:	270 OHIO RIVER BLVD
Second Line	:
City	:	BADEN
State	:	PA
Zip	:	15005-1914
Country	:	US
Telephone Number	:	724-869-2222
Fax Number	:	724-869-3155

Authorized Official
Title or Position	:	CEO/PROJECT DIRECTOR
Name	:	MR. RAY COLEMAN
Credential	:	LSW
Telephone Number	:	724-869-2222

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	10/05/2007

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Directions to “THE PREVENTION NETWORK ” Practice Location

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