Organization
IRENE STACY CMHC
Active
Parent organization
IRENE STACY CMHC
Other names
D&A Targeted Case Management
Organization subpart
Yes
Provider details
NPI number
Legal business name
IRENE STACY CMHC
Authorized official
ROGER KELLY LPC (EXECUTIVE DIRECTOR)
(724) 287-0791
Entity
Organization
Contact information
Practice address
112 HILLVUE DRIVE, BUTLER, PA 16001-3498
(724) 287-0791
(724) 287-2730
Mailing address
112 HILLVUE DRIVE, BUTLER, PA 16001-3498
(724) 287-0791
(724) 287-2730
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
101013
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003515 0114
—
PA
Enumeration date
12/31/2007
Last updated
12/31/2007
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