Provider Demographics
NPI:1669500872
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 1:1101 HARTMAN ST
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-1500
Practice Address - Country:US
Practice Address - Phone:412-673-5800
Practice Address - Fax:412-673-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA422510251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
648025OtherHIGHMARK
PA1007281380063Medicaid
111270OtherVALUE OPTIONS