1760526602 NPI number — ARMSTRONG COUNTY COUNCIL ON ALCOHOL AND OTHER DRUGS, 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 1760526602 NPI number — ARMSTRONG COUNTY COUNCIL ON ALCOHOL AND OTHER DRUGS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARMSTRONG COUNTY COUNCIL ON ALCOHOL AND OTHER DRUGS, 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:
ARC MANOR
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:
1760526602
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 OAK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KITTANNING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16201-2708
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEECHBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15656-1333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-845-7265
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WATTERSON
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
724-548-7607

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  037019 , 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: 037019 . This is a "FACILITY NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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