Provider Demographics
NPI:1093976300
Name:MERCY HOUSE OF MEADVILLE, INC.
Entity Type:Organization
Organization Name:MERCY HOUSE OF MEADVILLE, INC.
Other - Org Name:MERCY HOUSE DAY PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:KIGHTLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MA, CAC
Authorized Official - Phone:814-337-6180
Mailing Address - Street 1:13180 LESLIE RD
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-8478
Mailing Address - Country:US
Mailing Address - Phone:814-337-6180
Mailing Address - Fax:
Practice Address - Street 1:13180 LESLIE RD
Practice Address - Street 2:SUITE # 2
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-8478
Practice Address - Country:US
Practice Address - Phone:814-337-6180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health