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General NPI Number Information
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NPI Number | 1972598076
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Entity Type | Organization
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Legal Business Name | PHILHAVEN
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 283 S BUTLER RD
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City | LEBANON
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State | PA
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Zip | 17042-8939
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Country | US
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Telephone | 800-932-0359
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Fax |
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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Fax |
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Authorized Official
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Title or Position | VP & PRESIDENT PHILHAVEN
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Name | MANTHA KOTSALOS
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Credential |
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Telephone | 717-270-2423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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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 | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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