Provider Demographics
NPI:1710014113
Name:CRAIG ACADEMY
Entity Type:Organization
Organization Name:CRAIG ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-749-2879
Mailing Address - Street 1:751 N NEGLEY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-2059
Mailing Address - Country:US
Mailing Address - Phone:412-361-2801
Mailing Address - Fax:412-361-6775
Practice Address - Street 1:751 N NEGLEY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-2059
Practice Address - Country:US
Practice Address - Phone:412-361-2801
Practice Address - Fax:412-361-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA415950251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007756100002Medicaid