Provider Demographics
NPI:1982658308
Name:SQUIRREL HILL HEALTH CENTER
Entity Type:Organization
Organization Name:SQUIRREL HILL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREIDBERG KALSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-422-7442
Mailing Address - Street 1:4516 BROWNS HILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2917
Mailing Address - Country:US
Mailing Address - Phone:412-422-7442
Mailing Address - Fax:412-904-5025
Practice Address - Street 1:4516 BROWNS HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2917
Practice Address - Country:US
Practice Address - Phone:412-422-7442
Practice Address - Fax:412-904-5025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)