Provider Demographics
NPI:1497014385
Name:UNIVERSAL COMMUNITY BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:UNIVERSAL COMMUNITY BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BOLLING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:717-248-8197
Mailing Address - Street 1:25 ROTHERMEL DR
Mailing Address - Street 2:
Mailing Address - City:YEAGERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17099-9707
Mailing Address - Country:US
Mailing Address - Phone:717-248-8197
Mailing Address - Fax:717-248-6449
Practice Address - Street 1:25 ROTHERMEL DR
Practice Address - Street 2:
Practice Address - City:YEAGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:17099-9707
Practice Address - Country:US
Practice Address - Phone:717-248-8197
Practice Address - Fax:717-248-6449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN600285283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital