Organization
FAYETTE CO. DRUG & ALCOHOL COMMISSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA SHERBONDY (EXECUTIVE DIRECTOR)
(724) 438-3576
Entity
Organization
Contact information
Practice address
100 NEW SALEM RD, SUITE 106, UNIONTOWN, PA 15401-8936
(724) 438-3576
(724) 438-3305
Mailing address
100 NEW SALEM RD, SUITE 106, UNIONTOWN, PA 15401-8936
(724) 438-3576
(724) 438-3305
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007582440009
—
PA
01
—
1517783
BLUE SHIELD PROVIDER #
PA
01
—
53591
BLUE SHIELD PROVIDER #
PA
Enumeration date
01/28/2008
Last updated
01/28/2008
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