Keith Lodge in Wexford - Addiction (substance Use Disorder)
Keith Lodge - NPI 1104084714
Keith Lodge is a Addiction (substance Use Disorder) in Wexford, Pennsylvania. Keith Lodge practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Keith Lodge is 1104084714. The last update date is 2017-03-06.
Keith Lodge's current location address is 10164 Sudberry Dr, Wexford, Pennsylvania. You can contact this provider via phone number 7242844275. The mailing address for Keith Lodge is 10164 Sudberry Dr, Wexford, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Keith Lodge |
|---|---|
| Address | 10164 Sudberry Dr, Wexford, Pennsylvania |
| Phone Number | 7242844275 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.S.ED |
NPI Number Detail
| NPI Number | 1104084714 |
|---|---|
| Provider Enumeration Date | 2008-05-30 |
| Last Updated Date | 2017-03-06 |
Provider Mailing Address Detail
| Address | 10164 Sudberry Dr |
|---|---|
| City | Wexford |
| State | Pennsylvania (PA) |
| Post Code | 150909576 |
| Phone Number | 7242844275 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 25 400 761 |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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What is the unique 10-digit identifier code assigned to Keith Lodge by the Centers for Medicare & Medicaid Services?
The Keith Lodge has been issued the NPI (National Provider Identifier) 1104084714 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Keith Lodge is physically located?
The Keith Lodge is physically situated at the following address: 10164 Sudberry Dr, Wexford, PA, 150909576.
What is Keith Lodge's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Keith Lodge is Addiction (substance Use Disorder), and the taxonomy code that classifies this field of practice is 101Ya0400X.
On what date did the Centers for Medicare & Medicaid Services issue the 1104084714 to Keith Lodge?
The Keith Lodge received its 1104084714 assignment from the Centers for Medicare & Medicaid Services on 2008-05-30.
As of what date were the Keith Lodge's details last updated?
The information pertaining to the Keith Lodge, including its address, specialty, and other details, was most recently updated on 2017-03-06.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY