| Upmc Chautauqua At Wca | |
|
207 Foote Ave. Inpatient Mental Health Unit Jamestown NY 14701-7077 | |
| (716) 664-8640 | |
| (716) 664-8607 |
| Full Name | Upmc Chautauqua At Wca |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 207 Foote Ave., Jamestown, New York |
| Authorized Official Name and Position | Brad Dinger (CFO) |
| Authorized Official Contact | 8148773739 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upmc Chautauqua At Wca 600 Grant Street, Us Steel Tower, 59th Floor C/o Renee Johnson Pittsburgh PA 15219-2740 Ph: (412) 623-6303 | Upmc Chautauqua At Wca 207 Foote Ave. Inpatient Mental Health Unit Jamestown NY 14701-7077 Ph: (716) 664-8640 |
| NPI Number | 1063498889 |
|---|---|
| Provider Enumeration Date | 12/22/2005 |
| Last Update Date | 11/27/2023 |
| Certification Date | 10/22/2020 |
| Medicare PECOS PAC ID | 4385630342 |
|---|---|
| Medicare Enrollment ID | O20111109000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063498889 | NPI | - | NPPES |
| 1007520620019 | Medicaid | PA | |
| 00354623 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0602001H (New York) | Primary |
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