Provider Demographics
NPI:1780826412
Name:MENTAL HEALTH ASSOCIATION IN FAYETTE COUNTY
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION IN FAYETTE COUNTY
Other - Org Name:MHA IN FAYETTE COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:BAILOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-438-6738
Mailing Address - Street 1:100 NEW SALEM RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8936
Mailing Address - Country:US
Mailing Address - Phone:724-438-6738
Mailing Address - Fax:724-438-8484
Practice Address - Street 1:100 NEW SALEM RD
Practice Address - Street 2:SUITE 118
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8936
Practice Address - Country:US
Practice Address - Phone:724-438-6738
Practice Address - Fax:724-438-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable