Provider Demographics
NPI:1730203167
Name:YOUR CHILD'S PLACE
Entity type:Organization
Organization Name:YOUR CHILD'S PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:EALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-229-0851
Mailing Address - Street 1:190 N MAIN ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4349
Mailing Address - Country:US
Mailing Address - Phone:724-229-0851
Mailing Address - Fax:724-229-9252
Practice Address - Street 1:289 NORTH AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3512
Practice Address - Country:US
Practice Address - Phone:724-223-7801
Practice Address - Fax:724-223-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, PediatricGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty