Organization
MEADVILLE MEDICAL CENTER OUTPATIENT DRUG AND ALCOHOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENATO SUNTAY (CHIEF FINANCIAL OFFICER)
(814) 333-5031
Entity
Organization
Contact information
Practice address
1034 GROVE ST, MEADVILLE, PA 16335-2945
(814) 333-5810
(814) 333-5817
Mailing address
1034 GROVE ST, CBO, MEADVILLE, PA 16335-2945
(814) 373-2923
(814) 333-5640
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007521150021
—
PA
Enumeration date
01/23/2007
Last updated
10/14/2016
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