Provider Demographics
NPI:1154674760
Name:WESTMORELAND WEIGHT LOSS
Entity Type:Organization
Organization Name:WESTMORELAND WEIGHT LOSS
Other - Org Name:MEDTECH HEALTHCARE GROUP, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RICCIARDELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:724-834-1144
Mailing Address - Street 1:1037 COMPASS CIR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2786
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1037 COMPASS CIR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2786
Practice Address - Country:US
Practice Address - Phone:724-834-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty