1447560461 NPI number — RECOVERY CONCEPTS ADDICTION COUNSELING SERVICES, INC.

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 1447560461 NPI number — RECOVERY CONCEPTS ADDICTION COUNSELING SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RECOVERY CONCEPTS ADDICTION COUNSELING SERVICES, 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:
1447560461
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
233 E PITT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEDFORD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15522-1324
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-623-7370
Provider Business Mailing Address Fax Number:
814-623-7375

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
233 E PITT ST
Provider Second Line Business Practice Location Address:
SUITE # 6
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15522-1324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-623-7370
Provider Business Practice Location Address Fax Number:
814-623-7375
Provider Enumeration Date:
10/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BASSI
Authorized Official First Name:
LISA
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
PROJECT DIRECTOR
Authorized Official Telephone Number:
814-623-7370

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  057008 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 102038583001 . This is a "MEDICAL ASSISTANCE/CBHNP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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