Provider Demographics
NPI:1356331235
Name:COUNTY OF ALLEGHENY
Entity Type:Organization
Organization Name:COUNTY OF ALLEGHENY
Other - Org Name:JOHN J KANE REGIONAL CENTER-MCKEESPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:POLINAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-422-6050
Mailing Address - Street 1:955 RIVERMONT DR
Mailing Address - Street 2:ATTN: CHIEF FISCAL OFFICER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15207-1347
Mailing Address - Country:US
Mailing Address - Phone:412-422-6050
Mailing Address - Fax:412-422-6966
Practice Address - Street 1:100 9TH ST
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-3952
Practice Address - Country:US
Practice Address - Phone:412-422-6050
Practice Address - Fax:412-422-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA364702314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007463050048Medicaid
PA1007411200008Medicaid
PA1007411200008Medicaid