Provider Demographics
NPI:1851633622
Name:UNION MISSION OF LATROBE, INC.
Entity Type:Organization
Organization Name:UNION MISSION OF LATROBE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, RD
Authorized Official - Phone:724-537-8780
Mailing Address - Street 1:2217 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-3315
Mailing Address - Country:US
Mailing Address - Phone:724-539-3550
Mailing Address - Fax:724-532-3092
Practice Address - Street 1:2217 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-3315
Practice Address - Country:US
Practice Address - Phone:724-539-3550
Practice Address - Fax:724-532-3092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002222251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health