1306496047 NPI number — THREE RIVERS MUSIC THERAPY LLC

Table of content: (NPI 1306496047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306496047 NPI number — THREE RIVERS MUSIC THERAPY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THREE RIVERS MUSIC THERAPY LLC
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:
THREE RIVERS COMMUNITY CARE
Provider Other Organization Name Type Code:
3
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:
1306496047
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 VETERANS WAY STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARNEGIE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15106-4400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-206-9118
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 VETERANS WAY STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARNEGIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15106-4400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-206-9118
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2019

Additional Information

Authorized Official

Authorized Official Last Name:
BROADDRICK
Authorized Official First Name:
ALLISON
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
412-206-9118

Provider Taxonomy Codes

  • Taxonomy code: 225A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225XE0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XE1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XF0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XH1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XL0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XN1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0019X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XR0403X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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