Organization Name: | IRENE STACY COMMUNITY MENTAL HEALTH CENTER |
NPI Number: | 1063410207 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH HAUSER (EXECUTIVE DIRECTOR) |
Mailing Address: | 112 Hillvue Dr Butler |
State: | PA US |
Postal Code: | 160013426 |
Phone Number: | 7242870791 |
Fax Number: | 7242878354 |
NPI Enumeration Date: | 07/12/2005 |
NPI Last Update Date: | 05/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 423000 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |