MEDICARE: PASSAGES TO RECOVERY, 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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	707273	PA

General Provider Information

NPI Number	:	1972918597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASSAGES TO RECOVERY, INC.

Provider Business Mailing Address
First Line	:	564 FORBES AVE
Second Line	:	SUITE 930
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-2903
Country	:	US
Telephone Number	:	412-535-4310
Fax Number	:	412-535-4344

Provider Business Practice Location Address
First Line	:	1400 SOUTH BRADDOCK AVENNUE
Second Line	:	SECOND FLOOR
City	:	SWISSVALE
State	:	PA
Zip	:	15218-1264
Country	:	US
Telephone Number	:	412-281-7380
Fax Number	:	412-460-9002

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CAROL LYNN BENDER
Credential	:
Telephone Number	:	412-218-7380

Provider Enumeration Date	:	06/23/2014
Last Update Date	:	08/22/2024

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