# BEAVER COUNTY MH MR - D&A PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Beaver County Behavioral Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629292735
- **Authorized official:** GERARD MIKE (ADMINISTRATOR)
- **Authorized official phone:** (724) 847-6225

## Contact information

- **Practice address:** 1040 8TH AVE, HUMAN SERVICES BUILDING, FLOOR 2, BEAVER FALLS, PA 15010-4506
- **Practice address phone:** (724) 847-6225
- **Practice address fax:** (724) 891-2865
- **Mailing address:** 1040 8TH AVE, HUMAN SERVICES BUILDING, FLOOR 2, BEAVER FALLS, PA 15010-4506
- **Mailing address phone:** (724) 847-6225
- **Mailing address fax:** (724) 891-2865

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 04/12/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1007583980013 | — | PA |