Provider Demographics
NPI:1245770098
Name:ACMH HOSPITAL
Entity Type:Organization
Organization Name:ACMH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-543-8618
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-0579
Mailing Address - Country:US
Mailing Address - Phone:724-543-8553
Mailing Address - Fax:724-543-8616
Practice Address - Street 1:ONE NOLTE DRIVE
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-0579
Practice Address - Country:US
Practice Address - Phone:724-543-8553
Practice Address - Fax:724-543-8616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA940370273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007459070015Medicaid