Organization
ONLINE CARE GROUP PA-PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD GRAY (SVP)
(617) 204-3544
Entity
Organization
Contact information
Practice address
90 MARYLAND AVE, WEST MIFFLIN, PA 15122-4043
(540) 769-7891
Mailing address
PO BOX 1009, EAST ARLINGTON, MA 02474-0020
(540) 769-7891
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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