Provider Demographics
NPI:1447245915
Name:MARY & ALEXANDER LAUGHLIN CHILDREN'S CENTER
Entity Type:Organization
Organization Name:MARY & ALEXANDER LAUGHLIN CHILDREN'S CENTER
Other - Org Name:LAUGHLIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-741-4087
Mailing Address - Street 1:424 FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1523
Mailing Address - Country:US
Mailing Address - Phone:412-741-4087
Mailing Address - Fax:412-741-6808
Practice Address - Street 1:424 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1523
Practice Address - Country:US
Practice Address - Phone:412-741-4087
Practice Address - Fax:412-741-6808
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARY & ALEXANDER LAUGHLIN CHILDREN'S CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-12
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005396251OtherAETNA (NON-HMO)
PA1980174OtherCIGNA
PA1501945OtherGATEWAY HEALTH PLANS
PA0015858230003Medicaid
PA789444OtherPA BLUE SHIELD
PA0015858230003Medicaid