1386781037 NPI number — PENNSYLVANIA ORGANIZATION FOR WOMEN IN EARLY RECOVERY

Table of content: (NPI 1386781037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386781037 NPI number — PENNSYLVANIA ORGANIZATION FOR WOMEN IN EARLY RECOVERY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PENNSYLVANIA ORGANIZATION FOR WOMEN IN EARLY RECOVERY
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:
6
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:
1386781037
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
907 WEST ST
Provider Second Line Business Mailing Address:
SECOND FLOOR
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15221-2841
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-243-7535
Provider Business Mailing Address Fax Number:
412-243-8711

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7445 CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15218-2430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-271-0500
Provider Business Practice Location Address Fax Number:
412-271-4810
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
ROSA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
412-243-7535

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  707156 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X , with the licence number: 707221 , 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: 1007299680001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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