Provider Demographics
NPI:1063479483
Name:LATROBE AREA HOSPITAL, INC. - MENTAL HEALTH
Entity Type:Organization
Organization Name:LATROBE AREA HOSPITAL, INC. - MENTAL HEALTH
Other - Org Name:EXCELA HEALTH - LATROBE AREA HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-832-4030
Mailing Address - Street 1:121 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1068
Mailing Address - Country:US
Mailing Address - Phone:724-537-1650
Mailing Address - Fax:
Practice Address - Street 1:121 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1068
Practice Address - Country:US
Practice Address - Phone:724-537-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007610520006Medicaid
PA1007610520006Medicaid