Organization
PHILHAVEN
Active
Other names
WellSpan Philhaven Private Psychiatric Hospital, WellSpan Philhaven, WellSpan Philhaven Inpatient Psychiatric Unit
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
(800) 932-0359
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
—
—
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100772000-0175
—
PA
05
—
1007720000016
—
PA
05
—
1007720000121
—
PA
05
—
1007720000174
—
PA
01
—
318550
CERTIFICATE OF COMPLIANCE LICENSE NUMBER
PA
Enumeration date
09/14/2005
Last updated
04/28/2026
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