Organization
GOODWILL INDUSTRIES OF FAYETTE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE MITCHELL (VICE PRESIDENT OF AFFILIATE OPERATI)
(724) 437-9878
Entity
Organization
Contact information
Practice address
690 W MAIN ST, UNIONTOWN, PA 15401-2648
(724) 439-9311
Mailing address
44 CONNELLSVILLE STREET, UNIONTOWN, PA 15401
(724) 437-9878
(724) 437-9865
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
416340
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
472028
VALUEOPTIONS PROVIDER NUM
PA
Enumeration date
01/10/2007
Last updated
08/22/2020
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