Provider Demographics
NPI:1659988525
Name:PYRAMID HEALTHCARE, INC.
Entity Type:Organization
Organization Name:PYRAMID HEALTHCARE, INC.
Other - Org Name:PYRAMID HEALTHCARE NEWPORT NEWS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-940-0407
Mailing Address - Street 1:PO BOX 967
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-0967
Mailing Address - Country:US
Mailing Address - Phone:814-947-6823
Mailing Address - Fax:
Practice Address - Street 1:245 CHESAPEAKE AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23607-6038
Practice Address - Country:US
Practice Address - Phone:757-817-7570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility