Organization
FAYETTE RESOURCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE FOX (CFO)
(724) 437-6461
Entity
Organization
Contact information
Practice address
1313 CONNELLSVILLE RD, LEMONT FURNACE, PA 15456
(724) 437-6461
(724) 437-6107
Mailing address
1313 CONNELLSVILLE RD, LEMONT FURNACE, PA 15456
(724) 437-6461
(724) 437-6107
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
433950
PA
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100000658
MPI
PA
Enumeration date
05/04/2007
Last updated
02/15/2013
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