Provider Demographics
NPI:1326291261
Name:ARMSTRONG-INDIANA MH/MR PROGRAM
Entity Type:Organization
Organization Name:ARMSTRONG-INDIANA MH/MR PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/ EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KUEMMERLE
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW, LCSW
Authorized Official - Phone:724-548-3451
Mailing Address - Street 1:124 ARMSDALE RD
Mailing Address - Street 2:ARMSDALE ADMINISTRATION BUILDING, SUITE 105
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-3738
Mailing Address - Country:US
Mailing Address - Phone:724-548-3451
Mailing Address - Fax:724-548-3454
Practice Address - Street 1:124 ARMSDALE RD
Practice Address - Street 2:ARMSDALE ADMINISTRATION BUILDING, SUITE 105
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-3738
Practice Address - Country:US
Practice Address - Phone:724-548-3451
Practice Address - Fax:724-548-3454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health