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NPI Code Detail

MEDICARE: INTEGRATED BEHAVIORAL HEALTHCARE MANAGEMENT SERVICES, INC.

MEDICARE: INTEGRATED BEHAVIORAL HEALTHCARE MANAGEMENT SERVICES, INC.
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
1261QM0850XAdult Mental Health Clinic/Center313180PA
2261QM0855XAdolescent and Children Mental Health Clinic/Center313180PA
3261Q00000XClinic/Center313180PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11359155OTHERPABLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31350119OTHERPABLUE SHIELD (MANAGED CARE

General Provider Information

NPI Number : 1598874414
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATED BEHAVIORAL HEALTHCARE MANAGEMENT SERVICES, INC.
Provider Business Mailing Address
First Line : 900 BRYAN STREET
Second Line : SUITE 5
City : HUNTINGDON
State : PA
Zip : 16652
Country : US
Telephone Number : 814-643-6300
Fax Number : 814-643-8776
Provider Business Practice Location Address
First Line : 900 BRYAN ST
Second Line : SUITE 5
City : HUNTINGDON
State : PA
Zip : 16652-2413
Country : US
Telephone Number : 814-643-6300
Fax Number : 814-643-8776
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MR. MARK M. PETERS
Credential : M.A.
Telephone Number : 814-643-6300
Provider Enumeration Date : 08/30/2006
Last Update Date : 03/11/2021

Similar Medicare Providers

1760488878 — DR. RONALD FISHER M.D.
Practice Location Address:
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HUNTINGDON, PA
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Practice Fax: 814-643-8776
1326044421 — MOLLY ETTENGER M.D.
Practice Location Address:
900 BRYAN ST
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Practice Fax: 814-643-8299
1750352506 — CRESCENT D MILLER PA
Practice Location Address:
900 BRYAN ST STE 7
HUNTINGDON, PA
16652-2413
Practice Phone: 814-643-8600
Practice Fax:
1407818180 — MICHAEL F GAUGLER D.O.F.A.C.O.I.
Practice Location Address:
900 BRYAN ST STE 7
HUNTINGDON, PA
16652-2413
Practice Phone: 814-644-1141
Practice Fax: 814-643-9451
1366554784 — MARK M PETERS M.A.
Practice Location Address:
900 BRYAN ST , SUITE 5
HUNTINGDON, PA
16652-2413
Practice Phone: 814-643-6300
Practice Fax: 814-643-8776
1124130596 — MARTHA A JESSELL
Practice Location Address:
900 BRYAN ST , SUITE 5
HUNTINGDON, PA
16652-2413
Practice Phone: 814-643-6300
Practice Fax: 814-643-8776

Directions to “INTEGRATED BEHAVIORAL HEALTHCARE MANAGEMENT SERVICES, INC. ” Practice Location

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