Provider Demographics
NPI: | 1164989745 |
---|---|
Name: | STEEL CITY BEHAVIORAL HEALTH, LLC |
Entity Type: | Organization |
Organization Name: | STEEL CITY BEHAVIORAL HEALTH, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGING MEMBER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | STEPHANIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HANEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MSW |
Authorized Official - Phone: | 719-468-0547 |
Mailing Address - Street 1: | 3606 MORRIS AVE STE 111 |
Mailing Address - Street 2: | |
Mailing Address - City: | PUEBLO |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 81008-1369 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 719-468-0547 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3606 MORRIS AVE STE 111 |
Practice Address - Street 2: | |
Practice Address - City: | PUEBLO |
Practice Address - State: | CO |
Practice Address - Zip Code: | 81008-1369 |
Practice Address - Country: | US |
Practice Address - Phone: | 719-468-0547 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-03-01 |
Last Update Date: | 2021-07-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Single Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
No | 261QR1100X | Ambulatory Health Care Facilities | Clinic/Center | Research | |
No | 261QR1300X | Ambulatory Health Care Facilities | Clinic/Center | Rural Health | |
No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness | |
No | 3104A0630X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Behavioral Disturbances | |
No | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
No | 385H00000X | Respite Care Facility | Respite Care | Group - Single Specialty | |
No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child | Group - Single Specialty |