Healthcare Provider Details

I. General information

NPI: 1063732717
Provider Name (Legal Business Name): ST. JOSEPH INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 JACOBS WAY
PORT MATILDA PA
16870
US

IV. Provider business mailing address

134 JACOBS WAY
PORT MATILDA PA
16870-9240
US

V. Phone/Fax

Practice location:
  • Phone: 814-692-4954
  • Fax: 814-692-4485
Mailing address:
  • Phone: 814-692-4954
  • Fax: 814-692-4485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number147034
License Number StatePA

VIII. Authorized Official

Name: JAMES STEPHEN HINKLE
Title or Position: GENERAL COUNSEL & SECRETARY
Credential:
Phone: 615-637-7218