Provider Demographics
NPI:1376654053
Name:JAMES & CHAROLETTE ENTERPRISES INC.
Entity type:Organization
Organization Name:JAMES & CHAROLETTE ENTERPRISES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHESLEIGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-431-0711
Mailing Address - Street 1:160 SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15211-1910
Mailing Address - Country:US
Mailing Address - Phone:412-431-0711
Mailing Address - Fax:412-431-0732
Practice Address - Street 1:160 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15211-1910
Practice Address - Country:US
Practice Address - Phone:412-431-0711
Practice Address - Fax:412-431-0732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA669514OtherKEYSTONE HEALTH PLAN WEST
PA7771371OtherAETNA
PA1528183OtherCBHNP
PA100751029-0002Medicaid
PAA895014OtherVALUE OPTIONS
PA7771371OtherAETNA