| Invision Customized Services | |
|
12450 Perry Hwy Wexford PA 15090-7387 | |
| (724) 933-5100 | |
| (724) 933-4076 |
| Full Name | Invision Customized Services |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Location | 12450 Perry Hwy, Wexford, Pennsylvania |
| Authorized Official Name and Position | Ruth E Siegfried (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7249335100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Invision Customized Services 12450 Perry Hwy Wexford PA 15090-7387 Ph: (724) 933-5100 | Invision Customized Services 12450 Perry Hwy Wexford PA 15090-7387 Ph: (724) 933-5100 |
| NPI Number | 1134206220 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 06/28/2016 |
| Medicare PECOS PAC ID | 2769914811 |
|---|---|
| Medicare Enrollment ID | O20241015001722 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134206220 | NPI | - | NPPES |
| 100001898 | Medicaid | PA |
| Provider Name | Sudeep Gopal Chakravorty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790769123 PECOS PAC ID: 1557362068 Enrollment ID: I20070126000171 |
| Provider Name | Michael J Greisler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164509030 PECOS PAC ID: 1850557703 Enrollment ID: I20120723000424 |
| Provider Name | Anita Lynn Cilia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962846527 PECOS PAC ID: 8426481441 Enrollment ID: I20191205002098 |
| Provider Name | Darnell Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821737511 PECOS PAC ID: 5890176309 Enrollment ID: I20220714003286 |
| Provider Name | Faithe Bryant |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255019998 PECOS PAC ID: 0840642799 Enrollment ID: I20240503000032 |
| Provider Name | Lauren F Burling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326605171 PECOS PAC ID: 7113457839 Enrollment ID: I20250211002297 |
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