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400 Penn Lincoln Dr Imperial PA 15126-9781 | |
| (412) 749-7000 | |
| (412) 749-6761 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 400 Penn Lincoln Dr, Imperial, Pennsylvania |
| Authorized Official Name and Position | Robert M Rosenberger (CFO) |
| Authorized Official Contact | 7247734730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
400 Penn Lincoln Dr Imperial PA 15126-9781 Ph: (412) 749-7000 | 400 Penn Lincoln Dr Imperial PA 15126-9781 Ph: (412) 749-7000 |
| NPI Number | 1730411992 |
|---|---|
| Provider Enumeration Date | 02/12/2010 |
| Last Update Date | 06/14/2021 |
| Certification Date | 06/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730411992 | NPI | - | NPPES |
| 1000033550170 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 940070 (Pennsylvania) | Primary |
Elevate Psychological Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 27803 Evergreen Run, Imperial, PA 15126 Phone: 814-464-7565 | |
Community Support Advantage, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 36 Equestrian Dr, Imperial, PA 15126 Phone: 910-650-9827 |