PENNSYLVANIA MEDICAID MANAGED CARE ORGANIZATION (MCO) DIRECTORY
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1 PENNSYLVANIA MEDICAID MANAGED CARE ORGANIZATION (MCO) DIRECTORY JANUARY 2016 Healthchoices Physical Health Name of Contractor Contact Information Service Area Pharmacy Benefit Mgr: CVS/Caremark Contact Name/Number: Heather Gross Dental Benefit Mgr: DentaQuest Contact Name/Number: Kevin Woodbury Jason Rottman - CEO L/Cap Zone 2000 Market Street., Suite 850 Philadelphia, PA MCO Chief Medical Officer: Patricia Guerra- Garcia, M.D. MCO Contact: Darlene L. DeMore Director, Regulatory Compliance 3721 Tecport Drive Harrisburg, PA AmeriHealth Caritas Pennsylvania Phone: Fax: [email protected] Phone: [email protected] Phone: Fax: [email protected] Special Needs Unit: Pharmacy Benefit Mgr: Perform Rx Contact Name/Number: Ellan Baumgartner Dental Benefit Mgr: Scion Contact Name/Number: Ellan Baumgartner Marge Angello, RN Market President AmeriHealth Caritas Pennsylvania MCO Medical Director: Dr. Michael Baer Medical Director MCO Contact: Ellan Baumgartner Director, Regulatory Affairs AmeriHealth Caritas Pennsylvania 200 Stevens Drive Philadelphia, PA Phone: Fax: [email protected] Phone: Fax: [email protected] Phone: Fax: [email protected] Special Needs Unit Lehigh/Cap Zone Adams, Berks, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry and York Liz DeLuca TTY: TTY: Lehigh/Cap Zone Jim Peters TTY: TTY: Page 1 of 17 1/2016
2 Gateway Health Lehigh/Cap Zone Pharmacy Benefit Mgr: Argus Contact Name/Number: Regina Zembar (412) & Andrea Maxwell (412) Dental Benefit Mgr: UCCI Contact Name/Number: Regina Zembar (412) & Andrea Maxwell (412) Patricia J. Darnley President and Chief Executive Officer Gateway Health Plan, Inc. Four Gateway Center 444 Liberty Avenue, Suite 2100 Pittsburgh, PA MCO Medical Director: Dr. Michael Madden 21st Floor MCO Contact: Regina Zembar & Andrea Maxwell Government Affairs Specialists 19th Floor Address for all other GHP staff: Gateway Health Four Gateway Center 444 Liberty Avenue, Suite 2100 Pittsburgh, PA Phone: Fax: Phone: Fax: Phone: & Fax: UnitedHealthcare Community Plan of Pennsylvania Adams, Berks, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry and York Alinda Burrell TTY: TTY: Lehigh/Cap Zone Pharmacy Benefit Mgr: Optum Rx Contact Name/Number: Carol Lavoritano or Kiziann Powell Dental Benefit Mgr: DBP Contact Name/Number: Carol Lavoritano or Kiziann Powell Allison Davenport CEO United Healthcare Community Plan of PA The Wanamaker Bldg, Suite Penn Square East United Healthcare Community Plan of Pennsylvania Unison Plaza 1001 Brinton Road Pittsburgh, PA MCO Interim Medical Director: Barry M. Fabius 4051 Ogletown Road Newark, DE MCO Contact: Carol Lavoritano Manager, Strategic Programs The Wanamaker Bldg, Suite Penn Square East MCO Contact: Kiziann Powell Compliance Officer The Wanamaker Bldg, Suite Penn Square East Assistant: Tawnie Schubert Phone: Fax: Phone: Fax: Phone: Phone: Fax: Phone Fax: Adams, Berks, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry and York Mike Wilkinson TTY: TTY: Page 2 of 17 1/2016
3 , Inc. Pharmacy Benefit Mgr: ESI Contact Name/Number: Paul Kienzie Dental Benefit Mgr: Avesis Contact Name/Number: Bob Glass John Lovelace, President of Government Programs & Individual Advantage Products US Steel Tower 600 Grant Street, 55 th Floor MCO Medical Director: Dr. Nicholas Degregorio US Steel Tower-11 th Floor 600 Grant Street MCO Contact: Natalie Sifuentes MA Operations & Government Liaison US Steel Tower-9 th Floor 600 Grant Street Website: Phone: Fax: Phone: Fax: Phone: Fax: For correspondence For meetings Lehigh/Cap Zone Adams, Berks, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry and York Virginia Perry TTY: TTY: Name of Contractor Contact Information Service Area Pharmacy Benefit Mgr: CVS/Caremark Contact Number: Heather Gross Dental Benefit Mgr: DentaQuest Contact Number: Kevin Woodbury Jason Rottman, CEO SE Zone 2000 Market Street., Suite 850 Philadelphia, PA MCO Chief Medical Officer: Patricia Guerra- Garcia, M.D. MCO Contact: Darlene L. DeMore Director, Regulatory Compliance 3721 Tecport Drive Harrisburg, PA Phone: Fax: Phone: Phone: Fax: UnitedHealthcare Community Plan of Pennsylvania Southeast Zone : Bucks, Chester, Delaware, Montgomery, Philadelphia Liz Deluca TTY: TTY: Southeast Zone Pharmacy Benefit Mgr: Optum Rx Contact Name/Number: Carol Lavoritano or Kiziann Powell Dental Benefit Mgr: DBP Contact Name/Number: Carol Lavoritano or Kiziann Powell Allison Davenport CEO United Healthcare Community Plan of Pennsylvania (West Location) The Wanamaker Building 100 Penn Square East, Suite 410 Assistant: Tawnie Schubert Phone: Fax: [email protected] Bucks, Chester, Delaware, Montgomery and Philadelphia Page 3 of 17 1/2016
4 UnitedHealthcare Community Plan of Pennsylvania MCO Interim Medical Director: Barry M. Fabius 4051 Ogletown Road Newark, DE MCO Contact: Carol Lavoritano Manager, Strategic Programs The Wanamaker Building 100 Penn Square East, Suite 400 MCO Contact: Kiziann Powell Compliance Officer The Wanamaker Building 100 Penn Square East, Suite 400 Phone: Phone: Fax: Phone Fax Member Services Southeast Zone (cont d) Mike Wilkinson TTY: TTY: Name of Contractor Contact Information Service Area Health Partners Plans Pharmacy Benefit Mgr: Argus Contact Name/Number: Kearline D Jones & Pati Gaull (215) or (215) Dental Benefit Mgr: Avesis Contact Name/Number: Kearline D Jones & Pati Gaull (215) or (215) William George, President & CEO Health Partners Plans 901 Market Street, Suite 500 MCO Medical Director: Dr. Steven Szebenyi, M.D. 901 Market Street, Suite 500 MCO Contact: Kearline D. Jones Vice President of Government Relations & Compliance MCO Contact: Pati Gaull Director of Compliance Keystone First Phone: Fax: Phone: [email protected] Phone: Cell : Fax: [email protected] Phone: Fax: [email protected] Pharmacy Benefit Mgr: Perform Rx Contact Name/Number: Ellan Baumgartner Dental Benefit Mgr: Scion Contact Name/Number: Ellan Baumgartner Joanne McFall Market President Keystone First 200 Stevens Drive Philadelphia, PA Phone: Fax: [email protected] MCO Medical Director: Phone: Southeast Zone Bucks, Chester, Delaware, Montgomery and Philadelphia Bethany Garretson TTY: TTY: (Phil. local calls) Southeast Zone Page 4 of 17 1/2016
5 Dr. Y. Lily Higgins Medical Director 200 Stevens Drive Philadelphia, PA MCO Contact: Ellan Baumgartner Director, Regulatory Affairs Keystone First 200 Stevens Drive Philadelphia, PA Fax: # Phone: Fax: Jim Peters TTY: TTY: Name of Contractor Contact Information Service Area Gateway Health Pharmacy Benefit Mgr: Argus Contact Name/Number: Regina Zembar (412) & Andrea Maxwell (412) Dental Benefit Mgr: UCCI Contact Name/Number: Regina Zembar (412) & Andrea Maxwell (412) Patricia J. Darnley President and Chief Executive Officer Gateway Health Plan, Inc. Four Gateway Center 444 Liberty Avenue, Suite 2100 Pittsburgh, PA MCO Medical Director: Dr. Michael Madden Gateway Health-21st Floor MCO Contact: REGINA ZEMBAR & ANDREA MAXWELL Government Affairs Specialists Gateway Health-19th Floor Address for all other GHP staff: Gateway Health Four Gateway Center 444 Liberty Avenue, Suite 2100 Pittsburgh, PA Phone: Fax: Phone: Fax: Phone: & Fax: Pharmacy Benefit Mgr: CVS Caremark Contact Number: Heather Gross Dental Benefit Mgr: DentaQuest Contact Number: Kevin Woodbury Jason Rottman, CEO SE Zone 2000 Market Street., Suite 850 Philadelphia, PA MCO Chief Medical Officer: Patricia Guerra-Garcia, M.D. MCO Contact: Darlene L. DeMore Director, Regulatory Compliance 3721 Tecport Drive Harrisburg, PA Phone: Fax: Phone: Phone: Fax: Southwest Zone Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington and Westmoreland Alinda Burrell TTY: TTY: Southwest Zone Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington and Westmoreland Liz Deluca TTY: TTY: Page 5 of 17 1/2016
6 UnitedHealthcare Community Plan of Pennsylvania Southwest Zone Pharmacy Benefit Mgr: Optum Rx Contact Name/Number: Carol Lavoritano or Kiziann Powell Dental Benefit Mgr: DBP Contact Name/Number: Carol Lavoritano or Kiziann Powell Allison Davenport, CEO United Healthcare Community Plan of PA The Wanamaker Bldg, Suite Penn Square East MCO Medical Director: Barry M. Fabius 4051 Ogletown Road Newark, DE MCO Contact: Carol Lavoritano Manager, Strategic Programs United Healthcare The Wanamaker Bldg, Suite Penn Square East MCO Contact: Kiziann Powell Compliance Officer The Wanamaker Building 100 Penn Square East, Suite 400, Inc. Assistant: Tawnie Schubert Phone: Fax: Phone: Phone: Fax: Phone: Fax Pharmacy Benefit Mgr: ESI Contact Name/Number: Paul Kienzie Dental Benefit Mgr: Avesis Contact Name/Number: Bob Glass John Lovelace, President of Government Programs & Individual Advantage Products US Steel Building 600 Grant Street, 55 th Floor MCO Chief Medical Officer: Dr. Nicholas Degregorio US Steel Tower, 11 th Floor 600 Grant Street MCO Contact: Natalie Sifuentes MA Operations & Government Liaison US Steel Building 600 Grant Street,9 th Floor Phone: Fax: Phone: Fax: Phone: Fax: For correspondence For Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington and Westmoreland Mike Wilkinson TTY: TTY: Southwest Zone Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington and Westmoreland Virginia Perry Page 6 of 17 1/2016
7 AmeriHealth Northeast Pharmacy Benefit Mgr: Perform Rx Contact Name/Number: Ellan Baumgartner Dental Benefit Mgr: Scion Contact Name/Number: Ellan Baumgartner Marge Angello, RN Market President AmeriHealth Northeast MCO Medical Director: Dr. Michael Baer Medical Director MCO Contact: Ellan Baumgartner Director, Regulatory Affairs AmeriHealth Northeast 200 Stevens Drive Philadelphia, PA Geisinger Health Plan (Geisinger Family) Phone: Fax: Phone: Fax: Phone: Fax: Pharmacy Benefit Mgr: Medlmpact Contact Name/Number: Kelly Good (717) or (717) Dental Benefit Mgr: DentaQuest Contact Name/Number: Kelly Good (717) or (717) Steven R. Youso President & CEO 100 N. Academy Avenue Danville, PA Vacant Geisinger Health Plan Chief Government Programs Officer 100 N. Academy Avenue Danville, PA David Evans Vice President State Government Programs Geisinger Family MCO Medical Director: Perry Meadows Geisinger Family MCO Contact: Kelly Good HealthChoices Program Manager Geisinger Health Plan Phone: Phone: Phone: Phone: Phone: New East Zone Jim Peters TTY: TTY: New East Zone Bradford, Carbon, Centre, Clinton, Columbia, Juniata, Lackawanna, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northumberland, Pike, Schuylkill, Snyder, Sullivan, Susquehanna, Tioga, Union, Wayne & Wyoming Leroy Jefferys TTY: or Page 7 of 17 1/2016
8 Pharmacy Benefit Mgr: CVS Caremark Contact Number: Heather Gross Dental Benefit Mgr: DentaQuest Contact Number: Kevin Woodbury Jason Rottman, CEO SE Zone 2000 Market Street., Suite 850 Philadelphia, PA MCO Chief Medical Officer: Patricia Guerra-Garcia, M.D Market Street Philadelphia, PA MCO Contact: Darlene L. DeMore Director, Regulatory Compliance 3721 Tecport Drive Harrisburg, PA Phone: Fax: Phone: Phone: Fax: New East Zone Bucks, Chester, Delaware, Montgomery and Philadelphia Liz Deluca TTY: TTY: Name of Contractor Contact Information Service Area, Inc. New West Zone Pharmacy Benefit Mgr: ESI Contact Name/Number: Paul Kienzie Dental Benefit Mgr: Avesis Contact Name/Number: Bob Glass John Lovelace, President of Government Programs & Individual Advantage Products US Steel Building 600 Grant Street, 55 th Floor MCO Chief Medical Officer: Dr. Nicholas Degregorio US Steel Tower 11 th Floor 600 Grant Street MCO Contact: Natalie Sifuentes MA Operations & Government Liaison US Steel Building-9 th Floor 600 Grant Street Website: Phone: Fax: Phone: Fax: Phone: Fax: For all correspondence: For meeting invites only: TTY: Special needs: TTY: Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango & Warren Virginia Perry Page 8 of 17 1/2016
9 Gateway Health New West Zone Pharmacy Benefit Mgr: Argus Contact Name/Number: Regina Zembar (412) & Andrea Maxwell (412) Dental Benefit Mgr: UCCI Contact Name/Number: Regina Zembar (412) & Andrea Maxwell (412) Patricia J. Darnley President and Chief Executive Officer Gateway Health Plan, Inc. Four Gateway Center 444 Liberty Avenue, Suite 2100 Pittsburgh, PA MCO Medical Director: Dr. Michael Madden Gateway Health-21st Floor MCO Contact: REGINA ZEMBAR & ANDREA MAXWELL Government Affairs Specialists Gateway Health-19th Floor Address for all other GHP staff: Gateway Health Plan, Inc. Four Gateway Center 444 Liberty Avenue, Suite 2100 Pittsburgh, PA AmeriHealth Caritas Pennsylvania Phone: Fax: Phone: Fax: Phone: & Fax: Special Needs Unit Pharmacy Benefit Mgr: Perform Rx Contact Name/Number: Ellan Baumgartner Dental Benefit Mgr: Scion Contact Name/Number: Ellan Baumgartner Marge Angello, RN Market President AmeriHealth Caritas Pennsylvania MCO Medical Director: Dr. Michael Baer MCO Contact: Ellan Baumgartner Director, Regulatory Affairs AmeriHealth Caritas Pennsylvania 200 Stevens Drive Philadelphia, PA Phone: Fax: Phone: Fax: Phone: Fax: Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango & Warren DHS Contract Manager: Alinda Burrell TTY: TTY: New West Zone Jim Peters TTY: Special Needs Unit: TTY: Pharmacy Benefit Mgr: CVS Caremark Contact Name/Number: Heather Gross Dental Benefit Mgr: DentaQuest Contact Name/Number: Kevin Woodbury Jason Rottman, CEO SE Zone 2000 Market Street., Suite 850 Philadelphia, PA Phone: Fax: New West Zone Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango & Warren counties MCO Chief Medical Officer: Patricia Guerra-Garcia, M.D. Phone: MCO Contact: Darlene L. DeMore Phone: Page 9 of 17 1/2016
10 Director, Regulatory Compliance 3721 Tecport Drive Harrisburg, PA Fax: Liz Deluca HEALTHCHOICES BEHAVIORAL HEALTH Name of Contact Contact Information Service Area Scott Suhring, CEO Capital Area Behavioral Health Collaborative, Inc Vartan Way, Suite 206 Harrisburg, PA MCO Contact: James A. Laughman- Executive Director PO Box 6600 Matt Bauder, HealthChoices Administrator Lehigh County Government Center 17 South 7 th Street, 2 nd Floor Allentown, PA MCO Contact: Diane Marciano General Manager One Bethlehem Plaza 17 West Broad Street, Suite 210 Bethlehem, PA Lehigh/Capital Zone Phone: Fax: [email protected] Behavioral Health Subcontractor PerformCare Phone: Fax: [email protected] Phone: Fax: [email protected] Behavioral Health Subcontractor Magellan Behavioral Health Phone: Fax: [email protected] Cumberland, Dauphin, Lancaster, Lebanon and Perry Elizabeth Ricker Phone: Fax: [email protected] Lehigh County Marcy Rachko Phone: Fax: [email protected] Deborah Nunes, HealthChoices Coordinator Northampton County Dept. of Human Services - HealthChoices Program 2801 Emrick Boulevard Bethlehem, PA Behavioral Health Subcontractor Magellan Behavioral Health MCO Contact: Diane Marciano General Manager One Bethlehem Plaza 17 West Broad Street, Suite 210 Bethlehem, PA Phone: Fax: [email protected] Phone: Fax: [email protected] Northampton County Marcy Rachko Phone: Fax: [email protected] Page 10 of 17 1/2016
11 HealthChoices Behavioral Health Name of Contact Contact Information Service Area Michelle Hovis, Executive Director York County Human Services York County Government Center 100 West Market Street, 3 rd Floor York, PA Lehigh/Capital Zone Phone: Fax: [email protected] Adams and York Behavioral Health Subcontractor Community Care Behavioral Health Organization (CCBHO) MCO Contact: James Myers Regional Director 1200 Camp Hill Bypass, suite 100 Camp Hill, PA Phone: Fax: [email protected] Scott Liddick Phone: [email protected] (Adams County) (York County) (Spanish Line) Provider Line: Edward B. Michalik MH/DD Administrator Berks County MH/DD Program 633 Court Street, 8 th Floor Reading, PA Lydia Singley, Program Director Berks County MH/DD Program 633 Court Street, 8 th Floor Reading, PA Phone: Ext Fax: [email protected] Phone: Ext Fax: [email protected] Berks County Behavioral Health Subcontractor Community Care Behavioral Health Organization (CCBHO) MCO Contact: Jim Myers Regional Director 1200 Camp Hill Bypass, Suite 100 Camp Hill, PA Phone: Fax: [email protected] Marcy Rachko Phone: [email protected] (Spanish Line) Provider Line: Page 11 of 17 1/2016
12 Name of Contact Contact Information Service Area Northeast Zone James Gallagher-CEO NBHCC 72 Glenmaura National Boulevard Moosic, PA Phone: Lackawanna, Luzerne, Susquehanna and Wyoming Behavioral Health Subcontractor Community Care Behavioral Health Organization MCO Contact: Phone: Tina Wydeen, Regional Director Fax: Glenmaura National Boulevard, 2 nd Floor Moosic, PA [email protected] Lynn Wright Phone: [email protected] James Gavin, President and CEO Community Care BHO th Avenue Suite 1300 North/Central State Option Phone: Fax: [email protected] Provider Line: Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potter, Schuylkill, Snyder, Sullivan, Tioga, Union, Warren and Wayne Cindy Grezeszak, Director of Behavioral Health Department Bucks County Behavioral Health System Bucks County Courthouse Administration Building 600 Louis Drive Suite 102-A Doylestown, PA Behavioral Health Subcontractor Magellan Behavioral Health MCO Contact: Jim Leonard, LCSW, MBA Magellan Behavioral Health of PA 105 Terry Drive, Suite 103 Newtown, PA Southeast Zone Phone: Fax: [email protected] Phone: Fax: [email protected] Scott Liddick Phone: 717: Fax: [email protected] Bucks County Scott Ashenfelter Phone: Fax: [email protected] Bucks Chester Delaware Philadelphia Page 12 of 17 1/2016
13 Donna Carlson, BH Project Director Department of Human Services 601 Westtown Road, Suite 330 P.O. Box 2747 West Chester, PA Phone: Fax: Behavioral Health Subcontractor: Community Care Behavioral Health Community Care Behavioral Health One East Uwchlan Avenue, Suite 311 Exton, PA Chester County Treldon Johnson Phone: Fax: Southeast Zone Name of Contact Contact Information Service Area Jonna L. DiStefano, Administrator Delaware County Office of Behavioral Health 20 South 69 th Street, 3 rd Floor Upper Darby, PA Behavioral Health Subcontractor: Magellan Behavioral Health MCO Contact: Jim Leonard, LCSW, MBA Magellan Behavioral Health of PA 105 Terry Drive, Suite 103 Newtown, PA Dr. Arthur Evans, Director Dept. of Behavioral Health/Mental Retardation Services 1101 Market Street, 7 th Floor Behavioral Health Subcontractor Community Behavioral Health MCO Contact: Joan Erney-CEO 801 Market St, 7 th Floor LeeAnn Moyer, Deputy Administrator of Behavioral Health Montgomery County Behavioral Health Montgomery County Human Svcs. Center 1430 DeKalb Street, P.O. Box 311 Norristown, PA Behavioral Health Subcontractor Magellan Behavioral Health MCO Contact: Jim Leonard, LCSW, MBA Magellan Behavioral Health 105 Terry Drive, Suite 103 Newtown, PA Phone: Fax: [email protected] Phone: Fax: [email protected] Phone: Fax: [email protected] Phone: Fax: [email protected] Phone: Fax: [email protected] [email protected] Delaware County Scott Ashenfelter Phone: Fax: [email protected] Philadelphia County Treldon Johnson Phone: Fax: [email protected] Montgomery County Scott Ashenfelter Phone: Fax: [email protected] Page 13 of 17 1/2016
14 Name of Contact Contact Information Service Area David McAdoo Southwest Behavioral Health Management, Inc New Butler Road New Castle, PA Southwest Zone Phone: Fax: Behavioral Health Subcontractor Value Behavioral Health of Pennsylvania MCO Contact: Dr. Mark Fuller, CEO Phone: Pleasant Valley Road Fax: Trafford, PA Armstrong, Butler, Indiana, Lawrence, Washington and Westmoreland Lee An Kohler Phone: Fax: Diane Macerelli, Dep. Director of BH Allegheny County Office of Behavioral Health Human Services Building One Smithfield Street, 3 rd Floor Pittsburgh, PA Armstrong Butler Fayette Greene Indiana Lawrence Washington Westmoreland Phone: Fax: [email protected] Behavioral Health Subcontractor Community Care Behavioral Health Organization James Gavin, President and CEO Community Care BHO th Avenue [email protected] Suite 1300 Lisa Ferris-Kusniar, Administrator Fayette County Behavioral Health 215 Jacob Murphy Lane Uniontown, PA Phone: Fax: [email protected] Behavioral Health Subcontractor: Value Behavioral Health of Pennsylvania MCO Contact: Dr. Mark Fuller, CEO Phone: Pleasant Valley Road Trafford, PA Fax: Allegheny County Richard Latsko Phone: Fax: [email protected] Fayette County Scott Pino Phone: Fax: [email protected] Page 14 of 17 1/2016
15 Name of Contact Contact Information Service Area Dr. Mark Fuller, CEO Value Behavioral Health of PA 520 Pleasant Valley Road Trafford, PA Southwest Zone Phone: Fax: Greene County Gerard Mike, Administrator Beaver County MH/MR Program 1060 Eighth Avenue Beaver Falls, PA MCO Subcontractor: Value Behavioral Health MCO Contact: Dr. Mark Fuller, CEO 520 Pleasant Valley Road Trafford, PA Pamela Marple, HealthChoices Coordinator Behavioral Health Services of Bedford & Somerset (BHSSBC) 245 W. Race Street Somerset, PA Behavioral Health Subcontractor PerformCare MCO Contact: James A. Laughman- Executive Director PO Box 6600 Amy Marten-Shanafelt, Executive Director Blair HealthChoices 120 Holliday Hills Drive Hollidaysburg, PA Phone: Fax: Phone: Fax: North/Central County Option Zone Phone: Ext Fax: Phone: Fax: Phone: Fax: Behavioral Health Subcontractor Community Care Behavioral Health Community Care BHO th Avenue Suite Lee Ann Kohler Phone: Fax: [email protected] Beaver County Scott Pino Phone: Fax: [email protected] Bedford & Somerset Elizabeth Ricker Phone: Fax: [email protected] Blair County Angela Douglas Phone: Fax: [email protected] Page 15 of 17 1/2016
16 Name of Contact Contact Information Service Area Tracy Selak, Administrator Cambria county BH/ID Program 411 Main Street Johnstown PA cc: Ryan Hildebrand, CFO Behavioral Health of Cambria County Phone: Fax: Behavioral Health Subcontractor Value Behavioral Health of Pennsylvania Dr. Mark Fuller, CEO Phone: Value Behavioral Health of PA Fax: Pleasant Valley Road Trafford, PA Cambria County Richard Latsko Phone: Fax: Jeff Hartzell, HealthChoices Coordinator Phone: Carbon/Monroe/Pike MH/DS Program Ext Phillips Street, Suite 202 Fax: Stroudsburg, PA Behavioral Health Subcontractor: Community Care Behavioral Health Organization Beth Pickering, Regional Director One East Uwchlan Avenue, Suite 311 Exton, PA Phone: Fax: Deborah Duffy Lycoming/Clinton Joinder Board The Sharwell Building 200 East Street Williamsport, PA Phone: Fax: Behavioral Health Subcontractor: Community Care Behavioral Health Community Care BHO th Avenue Suite 1300 John DiMattio, DHS Director Erie County MH/MR Program 154 W. Ninth Street Erie, PA Phone: Fax: [email protected] Behavioral Health Subcontractor Community Care Behavioral Health Organization th Avenue Suite Carbon/Monroe/Pike Lynn Wright Phone: Fax: [email protected] Lycoming & Clinton Scott Liddick Phone: Fax: [email protected] Erie County Rich Latsko Phone: Fax: [email protected] Page 16 of 17 1/2016
17 Name of Contact Contact Information Service Area Melissa Reisinger, Executive Director The Tuscarora Managed Care Alliance Human Services Building 425 Franklin Farm Lane Chambersburg, PA Behavioral Health Subcontractor: PerformCare MCO Contact: James A. Laughman- Executive Director PO Box 6600 Dave McAdoo, Executive Director Northwest Behavioral Health Partnership, Inc New Butler Road New Castle, PA Phone: Phone: Fax: Phone: Fax: Behavioral Health Subcontractor: Value Behavioral Health of Pennsylvania Dr. Mark Fuller, CEO Value Behavioral Health of PA 520 Pleasant Valley Road Trafford, PA Phone: Fax: Franklin & Fulton Angela Douglas Phone: Fax: Crawford, Mercer, Venango Scott Pino Phone: Fax: Page 17 of 17 1/2016
Phone: 412-255-4640 Fax: 412-255-4504 www.gatewayhealthplan.com
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