Provider Demographics
NPI:1336574821
Name:THE BAIR FOUNDATION OF PENNSYLVANIA
Entity Type:Organization
Organization Name:THE BAIR FOUNDATION OF PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR OF MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-761-4260
Mailing Address - Street 1:241 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEW WILMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16142-1116
Mailing Address - Country:US
Mailing Address - Phone:724-946-2220
Mailing Address - Fax:
Practice Address - Street 1:245 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEW WILMINGTON
Practice Address - State:PA
Practice Address - Zip Code:16142-1116
Practice Address - Country:US
Practice Address - Phone:724-946-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA329980251J00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251J00000XAgenciesNursing Care