1508933599 NPI number — FAMILY BEHAVIORAL RESOURCES, INC.

Table of content: (NPI 1508933599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508933599 NPI number — FAMILY BEHAVIORAL RESOURCES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY BEHAVIORAL RESOURCES, INC.
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:
Provider Other Organization Name Type Code:
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:
1508933599
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
339 OLD HAYMAKER RD STE 209
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROEVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15146-1684
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-850-8118
Provider Business Mailing Address Fax Number:
724-850-9500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
131 MATHEWS ST
Provider Second Line Business Practice Location Address:
SUITE 2000
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-6939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-850-8118
Provider Business Practice Location Address Fax Number:
724-850-9500
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BLOUGH
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING
Authorized Official Telephone Number:
724-438-3011

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  422020 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0005X , with the licence number: 422020 , 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: 422020 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: 422020 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X , with the licence number: 422020 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X , with the licence number: 422020 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251K00000X , with the licence number: 436220 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: 422020 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: 436220 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X , with the licence number: 422020 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X , with the licence number: 332090 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X , with the licence number: 332080 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X , with the licence number: 422020 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X , with the licence number: 436220 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X , with the licence number: 422020 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2080107 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1839965 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 422020 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 332080 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 436220 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0197961 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007624160037 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007624160018 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 332090 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007624160038 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2127917 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 420340 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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