Organization
SAFE HARBOR BEHAVIORAL HEALTH OF UPMC HAMOT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN D EVANS (CEO & PRESIDENT)
(814) 459-9300
Entity
Organization
Contact information
Practice address
1330 W 26TH ST, ERIE, PA 16508-1402
(814) 459-9300
(814) 454-7780
Mailing address
1330 W 26TH ST, ERIE, PA 16508-1402
(814) 459-9300
(814) 454-7780
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100751136
—
PA
Enumeration date
06/23/2008
Last updated
06/05/2015
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