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General NPI Number Information
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NPI Number | 1174249189
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Entity Type | Organization
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Legal Business Name | PENNSYLVANIA HEALTH OPERATIONS LLC
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 09/13/2025
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Provider Practice Location Address
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Address Line | 1301 WRIGHTS LN E STE 103
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City | WEST CHESTER
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State | PA
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Zip | 19380-3442
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Country | US
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Telephone | 714-202-5166
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Fax | 866-273-8095
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Provider Business Mailing Address
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Address Line | L-4381
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City | COLUMBUS
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State | OH
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Zip | 43260-4381
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Country | US
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Telephone | 714-202-5166
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Fax |
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Authorized Official
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Title or Position | CHIEF LEGAL AND DEVELOPMENT OFFICER
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Name | KEITH THOMPSON
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Credential |
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Telephone | 949-462-4622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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