Organization
INTERVENTION FUNDAMENTALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL KEECH (OWNER)
(412) 438-3268
Entity
Organization
Contact information
Practice address
229 LIBERTO RD, PENN HILLS, PA 15235-2065
(412) 438-3268
Mailing address
229 LIBERTO RD, PENN HILLS, PA 15235-2065
(412) 438-3268
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
BH002964
PA
251S00000X
Community/Behavioral Health Agency
Primary
BH002964
PA
252Y00000X
Early Intervention Provider Agency
BH002964
PA
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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