NPIMap

Organization Active NPI

Chartiers Community Mental Health and Retardation Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bridgeville, PA
National Provider Identifier
1275526642
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC
Practice address
437 Railroad Street
Bridgeville, PA 15017
Phone
(412) 221-3302
Fax
(412) 221-4902
NPI assigned
Aug 31, 2005
Last updated
Apr 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan A Coyle
Title
Ceo
Phone
(412) 221-3302

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X PA Primary

Addresses

Primary practice location

437 Railroad Street
Bridgeville, PA 15017

Mailing address

437 Railroad Street
Bridgeville, PA 15017
Phone (412) 221-3302

Other identifiers 1

IdentifierTypeStateIssuer
100002895MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000821 PA Part B Supplier - Clinic/Group Practice 2466341573 Receives reassigned benefits from 14 practitioners
Practice locations: Bridgeville, PA; Pittsburgh, PA; Washington, PA

National Provider Directory

National Provider Directory

Locations

515 Washington Ave
Bridgeville, PA 15017
Phone (412) 221-9001

90 W Chestnut St
Ste 250
Washington, PA 15301
Phone (412) 221-3302

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1275526642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 RAILROAD STREET",
            "city": "BRIDGEVILLE",
            "state": "PA",
            "postal_code": "15017",
            "telephone_number": "412-221-3302",
            "fax_number": "412-221-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 RAILROAD STREET",
            "city": "BRIDGEVILLE",
            "state": "PA",
            "postal_code": "15017",
            "telephone_number": "412-221-3302",
            "fax_number": "412-221-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "COYLE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "412-221-3302"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002895",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.