Provider Demographics
NPI:1699049726
Name:LYTLE BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:LYTLE BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-921-7000
Mailing Address - Street 1:160 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-1741
Mailing Address - Country:US
Mailing Address - Phone:412-921-7000
Mailing Address - Fax:
Practice Address - Street 1:21351 GENTRY DR
Practice Address - Street 2:SUITE 250
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-8510
Practice Address - Country:US
Practice Address - Phone:412-921-7000
Practice Address - Fax:412-921-7261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty