Provider Demographics
NPI:1609044874
Name:TURTLE CREEK VALLEY MH/MR, INC.
Entity Type:Organization
Organization Name:TURTLE CREEK VALLEY MH/MR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEEDY BOST
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:412-351-0222
Mailing Address - Street 1:723 BRADDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:BRADDOCK
Mailing Address - State:PA
Mailing Address - Zip Code:15104-1849
Mailing Address - Country:US
Mailing Address - Phone:412-351-0222
Mailing Address - Fax:412-351-2616
Practice Address - Street 1:70 S 22ND ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2143
Practice Address - Country:US
Practice Address - Phone:412-381-2100
Practice Address - Fax:412-381-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007281380065Medicaid