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Organization
SPINA BIFIDA ASSOCIATION OF WESTERN PA
Active
Organization
SPINA BIFIDA ASSOCIATION OF WESTERN PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY ANN BAYUK (EXECUTIVE DIRECTOR)
(724) 934-9600
Entity
Organization
Contact information
Practice address
3000 STONEWOOD DR STE 100, WEXFORD, PA 15090-8317
(724) 934-9600
(724) 934-9610
Mailing address
3000 STONEWOOD DR STE 100, WEXFORD, PA 15090-8317
(724) 934-9600
(724) 934-9610
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
10253601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001941320
PROMISE ID
PA
Enumeration date
11/15/2017
Last updated
11/15/2017
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