Provider Demographics
NPI:1760526602
Name:ARMSTRONG COUNTY COUNCIL ON ALCOHOL AND OTHER DRUGS, INC
Entity Type:Organization
Organization Name:ARMSTRONG COUNTY COUNCIL ON ALCOHOL AND OTHER DRUGS, INC
Other - Org Name:ARC MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LPC
Authorized Official - Phone:724-548-7607
Mailing Address - Street 1:200 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-2708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEECHBURG
Practice Address - State:PA
Practice Address - Zip Code:15656-1333
Practice Address - Country:US
Practice Address - Phone:724-845-7265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARMSTRONG COUNTY COUNCIL ON ALCOHOL AND OTHER DRUGS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-16
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA037019251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA037019OtherFACILITY NUMBER