Provider Demographics
NPI:1598191082
Name:PASSAVANT MEMORIAL HOMES
Entity Type:Organization
Organization Name:PASSAVANT MEMORIAL HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:WERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-820-1015
Mailing Address - Street 1:100 PASSAVANT WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1318
Mailing Address - Country:US
Mailing Address - Phone:412-820-1015
Mailing Address - Fax:412-820-1025
Practice Address - Street 1:419 CARNEGIE RD
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:PA
Practice Address - Zip Code:15089-3092
Practice Address - Country:US
Practice Address - Phone:412-820-1015
Practice Address - Fax:412-820-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA444150251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health