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NPI Code Detail

MEDICARE: MERCY LIFE CENTER CORPORATION

MEDICARE: MERCY LIFE CENTER CORPORATION
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
1251B00000XCase Management Agency
2251C00000XDevelopmentally Disabled Services Day Training Agency
3251K00000XPublic Health or Welfare Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5550856OTHERHIGH MARK MGD CARE

General Provider Information

NPI Number : 1720075104
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY LIFE CENTER CORPORATION
Provider Business Mailing Address
First Line : 1200 REEDSDALE ST
Second Line : MERCY BEHAVORIAL HEALTH
City : PITTSBURGH
State : PA
Zip : 15233-2109
Country : US
Telephone Number : 412-697-0712
Fax Number : 412-323-4507
Provider Business Practice Location Address
First Line : 1200 REEDSDALE ST
Second Line : MERCY BEHAVORIAL HEALTH
City : PITTSBURGH
State : PA
Zip : 15233-2109
Country : US
Telephone Number : 412-323-4543
Fax Number : 412-323-4507
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. RAYMOND WOLFE
Credential :
Telephone Number : 412-323-4564
Provider Enumeration Date : 09/30/2005
Last Update Date : 01/13/2012

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1467501312 — MERCY LIFE CENTER CORPORATION
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15233-2109
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Practice Fax: 412-323-4507

Directions to “MERCY LIFE CENTER CORPORATION ” Practice Location

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