Organization
PHILHAVEN
Active
Other names
WellSpan Philhaven Partial Hospital, WellSpan Philhaven
Organization subpart
No
Provider details
NPI number
Authorized official
MANTHA KOTSALOS (VP & PRESIDENT PHILHAVEN)
(717) 270-2423
Entity
Organization
Contact information
Practice address
283 S BUTLER RD, LEBANON, PA 17042-8939
(717) 270-2405
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007720000037
—
PA
05
—
1007720000054
—
PA
05
—
1007720000115
—
PA
05
—
1007720000145
—
PA
Enumeration date
09/15/2006
Last updated
06/05/2024
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