1831118058 NPI number — THE HIGHLAND HOUSE, INC

Table of content: (NPI 1831118058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831118058 NPI number — THE HIGHLAND HOUSE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HIGHLAND HOUSE, 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:
1831118058
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1405
Provider Second Line Business Mailing Address:
101 S. MERCER ST. CENTRAL BUILDING, SUITE 202
Provider Business Mailing Address City Name:
NEW CASTLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16103-1405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-856-7349
Provider Business Mailing Address Fax Number:
724-856-7353

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
312 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101-3670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-654-7760
Provider Business Practice Location Address Fax Number:
724-654-9845
Provider Enumeration Date:
07/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PLOTTS
Authorized Official First Name:
MARILYN
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
724-856-7349

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  377010 , 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: 1010798300001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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