Organization
MENTAL HEALTH ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE M SIMMS (FISCAL TECHNICIAN)
(724) 225-2061
Entity
Organization
Contact information
Practice address
225 SPRING ST, BENTLEYVILLE, PA 15314-1252
(724) 239-3993
(724) 239-3997
Mailing address
15 S COLLEGE ST, WASHINGTON, PA 15301-4821
(724) 225-2061
(724) 225-4770
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
424660
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101722148 0004
PROMISE ID
PA
01
—
582217
VALUE OPTIONS PROVIDER NUMBER
PA
Enumeration date
05/19/2008
Last updated
05/19/2008
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