| Brookville Behavioral Health Inc. | |
|
3 S Brady St Ste 205 Du Bois PA 15801-2159 | |
| (814) 371-1088 | |
| (814) 371-4966 |
| Full Name | Brookville Behavioral Health Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3 S Brady St Ste 205, Du Bois, Pennsylvania |
| Authorized Official Name and Position | Ronald Floyd Park (CEO) |
| Authorized Official Contact | 8143711088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookville Behavioral Health Inc. 3 S Brady St Ste 205 Du Bois PA 15801-2159 Ph: (814) 371-1088 | Brookville Behavioral Health Inc. 3 S Brady St Ste 205 Du Bois PA 15801-2159 Ph: (814) 371-1088 |
| NPI Number | 1326117359 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 11/13/2020 |
| Certification Date | 11/11/2020 |
| Medicare PECOS PAC ID | 8527093061 |
|---|---|
| Medicare Enrollment ID | O20070327000561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326117359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 423220 (Pennsylvania) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Janet Marie Keslar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326306820 PECOS PAC ID: 0244495133 Enrollment ID: I20120627000075 |
| Provider Name | Deena Marie Laughlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063815405 PECOS PAC ID: 3476884024 Enrollment ID: I20191011001455 |
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