1790856656 NPI number — UPMC BEHAVIORAL HEALTH OF THE ALLEGHENIES

Table of content: (NPI 1790856656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790856656 NPI number — UPMC BEHAVIORAL HEALTH OF THE ALLEGHENIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC BEHAVIORAL HEALTH OF THE ALLEGHENIES
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:
1790856656
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 E CHESTNUT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALTOONA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16601-5215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-940-7457
Provider Business Mailing Address Fax Number:
814-569-1019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 E CHESTNUT AVE
Provider Second Line Business Practice Location Address:
ADULT PARTIAL PROGRAM
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16601-5215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-943-0414
Provider Business Practice Location Address Fax Number:
814-943-6198
Provider Enumeration Date:
11/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHUFF
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR, BEHAVIORAL HEAL
Authorized Official Telephone Number:
814-940-7457

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  360420 , 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: 263087 . This is a "HIGHMARK & PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1652320 . This is a "HIGHMARK AND PA BLUE SHIE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1000007650040 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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