Provider Demographics
NPI:1447384573
Name:PRESSLEY RIDGE
Entity type:Organization
Organization Name:PRESSLEY RIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR ACCOUNTING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-321-6995
Mailing Address - Street 1:530 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15214-3016
Mailing Address - Country:US
Mailing Address - Phone:412-321-6995
Mailing Address - Fax:412-321-7008
Practice Address - Street 1:2580 GRANT GDNS
Practice Address - Street 2:
Practice Address - City:ONA
Practice Address - State:WV
Practice Address - Zip Code:25545-9731
Practice Address - Country:US
Practice Address - Phone:304-743-3648
Practice Address - Fax:304-743-1147
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESSLEY RIDGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-14
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0023803006Medicaid
WV0023803003Medicaid