Provider Demographics
NPI:1821524448
Name:PENNSYLVANIA ORGANIZATION OF WOMEN IN EARLY RECOVERY
Entity Type:Organization
Organization Name:PENNSYLVANIA ORGANIZATION OF WOMEN IN EARLY RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, ACSW
Authorized Official - Phone:412-243-7535
Mailing Address - Street 1:7501 PENN AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2560
Mailing Address - Country:US
Mailing Address - Phone:412-243-8755
Mailing Address - Fax:412-243-8711
Practice Address - Street 1:7501 PENN AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-2560
Practice Address - Country:US
Practice Address - Phone:412-243-8755
Practice Address - Fax:412-243-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA707205251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health