Provider Demographics
NPI:1841476587
Name:COMMUNITY EMPOWERMENT ASSOCIATION INC
Entity type:Organization
Organization Name:COMMUNITY EMPOWERMENT ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAYTONA
Authorized Official - Middle Name:ELODIA
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MSLBE
Authorized Official - Phone:412-371-3689
Mailing Address - Street 1:400 N LEXINGTON AVENUE
Mailing Address - Street 2:BUILDING 500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208
Mailing Address - Country:US
Mailing Address - Phone:412-371-3689
Mailing Address - Fax:412-371-0792
Practice Address - Street 1:400 N LEXINGTON AVENUE
Practice Address - Street 2:BUILDING 500
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208
Practice Address - Country:US
Practice Address - Phone:412-371-3689
Practice Address - Fax:412-371-0792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10001242083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23282OtherCCBHO PAY ID
1000124OtherCCBHO PROMISE