Provider Demographics
NPI:1881656437
Name:ALLEGHENY LUTHERAN SOCIAL MINISTRIES
Entity Type:Organization
Organization Name:ALLEGHENY LUTHERAN SOCIAL MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PH D, NHA
Authorized Official - Phone:814-696-4500
Mailing Address - Street 1:915 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2247
Mailing Address - Country:US
Mailing Address - Phone:814-696-4500
Mailing Address - Fax:
Practice Address - Street 1:231 TABERNACLE DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2660
Practice Address - Country:US
Practice Address - Phone:814-445-8506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA091080373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001998070031Medicaid