Organization
LAURELCARE SOUTH/WEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARYN GEORGE (CHIEF OPERATING OFFICER)
(412) 458-6565
Entity
Organization
Contact information
Practice address
1200 BROOKS LN STE 210, JEFFERSON HILLS, PA 15025-3761
(412) 458-6565
Mailing address
1200 BROOKS LN STE 210, JEFFERSON HILLS, PA 15025-3761
(412) 458-6565
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037574470001
—
PA
Enumeration date
09/23/2020
Last updated
09/23/2020
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