1194787234 NPI number — HEALING BRIDGES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194787234 NPI number — HEALING BRIDGES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING BRIDGES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WASHINGTON COMMUNITIES HUMAN SERVICES INC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194787234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
378 WEST CHESTNUT ST.
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-225-6940
Provider Business Mailing Address Fax Number:
724-225-6811

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
378 WEST CHESTNUT ST
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-225-6940
Provider Business Practice Location Address Fax Number:
724-225-6811
Provider Enumeration Date:
04/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROSS
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
724-225-6940

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  439920 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TB0200X , with the licence number: 439920 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 439920 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 439920 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 047847 . This is a "HIGHMARK INDEMNITY PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 108953 . This is a "VALUEOPTIONS HEALTH CHOIC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: HIGHMARK . This is a "HIGHMARK INDEMNITY NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0553010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 276223 . This is a "HIGHMARK MCI NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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