Provider Demographics
NPI:1952456139
Name:WESLEY SPECTRUM SERVICES
Entity Type:Organization
Organization Name:WESLEY SPECTRUM SERVICES
Other - Org Name:THE WESLEY INSTITUTE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIETRZAK
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:412-342-2288
Mailing Address - Street 1:221 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:WILKINSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15221-2118
Mailing Address - Country:US
Mailing Address - Phone:412-342-2288
Mailing Address - Fax:412-342-2300
Practice Address - Street 1:26 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-6812
Practice Address - Country:US
Practice Address - Phone:724-222-7500
Practice Address - Fax:412-342-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA637032101YA0400X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA329484A013419OtherVBH OF PA
PA1001340160027Medicaid