Provider Demographics
NPI:1710041322
Name:ADDICTION SPECIALISTS, INC
Entity Type:Organization
Organization Name:ADDICTION SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROZ
Authorized Official - Middle Name:S
Authorized Official - Last Name:SUGARMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:412-292-8899
Mailing Address - Street 1:PO BOX H
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-0520
Mailing Address - Country:US
Mailing Address - Phone:724-437-2776
Mailing Address - Fax:724-437-2227
Practice Address - Street 1:1023 PITTSBURGH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-0520
Practice Address - Country:US
Practice Address - Phone:724-437-2776
Practice Address - Fax:724-437-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA267007261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA345498OtherVALUE OPTIONS
PA0017630770001Medicaid