Organization
WADDINGTON REHAB CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA MOUX (CREDENTIALING MANAGER)
(724) 483-4282
Entity
Organization
Contact information
Practice address
701 PENN AVE, NEW BRIGHTON, PA 15066-1362
(724) 483-4282
(724) 483-4078
Mailing address
100 STOOPS DR STE 240, MONONGAHELA, PA 15063-3553
(724) 483-4282
(724) 453-4078
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103789549002
—
PA
Enumeration date
03/15/2022
Last updated
03/15/2022
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