Healthcare Provider Details

I. General information

NPI: 1427265743
Provider Name (Legal Business Name): NHS STEVENS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S 1ST ST
MC CONNELLSBURG PA
17233-1308
US

IV. Provider business mailing address

4251 CRUMS MILL RD
HARRISBURG PA
17112-2824
US

V. Phone/Fax

Practice location:
  • Phone: 215-836-3131
  • Fax: 215-273-5975
Mailing address:
  • Phone: 215-836-3131
  • Fax: 215-273-5975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1007592600003
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MR. NORMAN TILSON
Title or Position: DIRECTOR OF BUSINESS OPERATIONS
Credential:
Phone: 215-836-3131