Provider Demographics
NPI:1912455320
Name:PRESSLEY RIDGE
Entity Type:Organization
Organization Name:PRESSLEY RIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-872-9458
Mailing Address - Street 1:5500 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5848
Mailing Address - Country:US
Mailing Address - Phone:412-872-9422
Mailing Address - Fax:412-872-9478
Practice Address - Street 1:8501 LASALLE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5914
Practice Address - Country:US
Practice Address - Phone:667-206-5210
Practice Address - Fax:412-872-9478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1492251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD962451101Medicaid