Organization
ADELPHOI VILLAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA MALDET (DIRECTOR OF REVENUE CYCLE MANAGEMEN)
(724) 804-7159
Entity
Organization
Contact information
Practice address
1119 VILLAGE WAY, LATROBE, PA 15650-5201
(724) 520-1111
(724) 520-1878
Mailing address
1119 VILLAGE WAY, LATROBE, PA 15650-5201
(724) 520-1111
(724) 520-1878
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
423910
PA
2084F0202X
Forensic Psychiatry Physician
423910
PA
2084N0400X
Neurology Physician
423910
PA
2084P0005X
Neurodevelopmental Disabilities Physician
423910
PA
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007447300019
—
PA
Enumeration date
03/26/2007
Last updated
11/24/2020
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