Organization
MEADVILLE MEDICAL CENTER OUTPATIENT DRUG AND ALCOHOL
Active
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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