Provider Demographics
NPI:1073773230
Name:STAIRWAYS BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:STAIRWAYS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ERNST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-464-8311
Mailing Address - Street 1:2185 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4747
Mailing Address - Country:US
Mailing Address - Phone:814-464-8311
Mailing Address - Fax:814-453-4757
Practice Address - Street 1:2185 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4747
Practice Address - Country:US
Practice Address - Phone:814-464-8311
Practice Address - Fax:814-453-4757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA405900261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000063480008Medicaid