Provider Demographics
NPI:1548568447
Name:MARY AND ALEXANDER LAUGHLIN CHILDREN'S CENTER
Entity Type:Organization
Organization Name:MARY AND ALEXANDER LAUGHLIN CHILDREN'S CENTER
Other - Org Name:LAUGHLIN CHILDREN'S 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 AND ALEXANDER LAUGHLIN CHILDREN'S CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-02
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA489410OtherTRICARE
PA2590082OtherHIGHMARK BLUE CROSS BLUE SHIELD
PA0015858230004Medicaid