WELLSPAN PHILHAVEN RESIDENTIAL (NPI# 1013132992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013132992 |
| Entity Type | Organization |
| Organization Name | WELLSPAN PHILHAVEN RESIDENTIAL |
| Practice Address |
283 S Butler Rd Mt Gretna PA 17064 |
| Mailing Address |
283 S Butler Rd Mt Gretna PA 17064-0550 |
| Practice Telephone | 8009320359 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2018-07-27 |
| Authorized Official Name | PHILLIP D HESS (CEO) |
| Authorized Official Telephone | 8009320359 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007720000001 | 05 |
| Street Address |
283 S BUTLER RD |
| City | MT GRETNA |
| State | PA |
| Zip Code | 17064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942451257 | Tammy A Lazicki | Psychologist | 283 S Butler Rd, Mt Gretna, PA 17064-0550 | 2008-10-06 |
| 1043460983 | Shanley Possemato O'donnell | Counselor | 283 S Butler Rd, Mt Gretna, PA 17064-0550 | 2008-09-29 |
| 1891977872 | Lance C Couturier | Psychologist | 283 S Butler Rd, Mt Gretna, PA 17064-0550 | 2007-11-30 |
| 1033398516 | Christine M Breeden | Psychologist | 283 S Butler Rd, Mt Gretna, PA 17064-0550 | 2007-10-31 |
| 1841499662 | Sheila A Mc Dermott Lord | Registered Nurse | 283 S Butler Rd, Mt Gretna, PA 17064-0550 | 2007-07-12 |
| 1295937340 | Robyn E Johns | Psychologist | 283 S Butler Rd, Mt Gretna, PA 17064-0550 | 2007-06-01 |
| 1992925200 | Ralph G Whitaker | Counselor | 283 S Butler Rd, Mt Gretna, PA 17064-0550 | 2007-04-27 |
| 1528283678 | Philhaven | Psychiatric Hospital | 283 S Butler Rd, Mt Gretna, PA 17064 | 2007-04-16 |
| 1417172545 | Philhaven | Psychiatric Hospital | 283 S Butler Rd, Mt Gretna, PA 17064 | 2007-04-16 |
| 1659434892 | Ted A Hummel | Psychologist | 283 S Butler Rd, Mt Gretna, PA 17064-0550 | 2006-12-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699130245 | Elizabeth Grace Jackson | Counselor | Philhaven 283 Butler Road, Mt Gretna, PA 17064 | 2015-12-28 |
| 1952781023 | Jennifer Taylor | Counselor | 283 S. Butler Road, Mt Gretna, PA 17064 | 2015-06-04 |
| 1215379318 | James Owen Rimel Jr. | Social Worker | 283 Butler Road, Mt. Gretna, PA 17064 | 2013-07-18 |
| 1548554884 | Cynthia Theresa Fonder | Psychiatry & Neurology | 283 S. Butler Rd, Mt. Gretna, PA 17064 | 2011-06-03 |
| 1518286491 | Pa Evaluations, LLC | Clinic/Center | 302 6th St., Mount Gretna, PA 17064 | 2010-05-18 |
| 1942451471 | Glenn Acker | Psychologist | 304 Sixth St, Mount Gretna, PA 17064 | 2008-10-02 |
| 1619195070 | John Francis Dolena | Psychiatry & Neurology | 283 S. Butler Rd., Philhaven Behavioral Health Services, Mt Gretna, PA 17064 | 2007-04-23 |
| 1487878773 | Philhaven Residential | Psychiatric Residential Treatment Facility | 643 Horseshoe Pk, Lebanon, PA 17064 | 2007-04-11 |
| 1487665857 | Jose Angel Alfano | Psychiatry & Neurology | 283 South Butler Road, Mt Gretna, PA 17064 | 2006-08-11 |
| 1275563140 | Olaniyi I Oluleye | Psychiatry & Neurology | 283 S Butler Road, Mt Gretna, PA 17064 | 2006-07-04 |
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| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750913752 | Legacy Treatment Services, Inc. | Psychiatric Residential Treatment Facility | 5732 Thomas Ave, Philadelphia, PA 19143-4523 | 2020-02-07 |
| 1649802646 | Legacy Treatment Services, Inc. | Psychiatric Residential Treatment Facility | 1187 E Washington Ln, Philadelphia, PA 19138-1061 | 2020-02-07 |
| 1467097675 | Children's Center for Treatment and Education | Psychiatric Residential Treatment Facility | 1214 Freeport Rd, Kittanning, PA 16201-4564 | 2019-11-12 |
| 1144888272 | Perseus House, Inc | Psychiatric Residential Treatment Facility | 516 W 7th St, Erie, PA 16502-1333 | 2019-06-04 |
| 1003328071 | Children's Center for Treatment and Education | Psychiatric Residential Treatment Facility | 585 E Main St, Youngsville, PA 16371-1129 | 2017-10-31 |
| 1750746087 | The Devereux Foundation | Psychiatric Residential Treatment Facility | 160 Devereux Rd, Brandywine Rtf - Dormitory 1 Schwartz, Glenmoore, PA 19343-1615 | 2015-12-31 |
| 1588052609 | Perseus House Inc | Psychiatric Residential Treatment Facility | 643 E 6th St, Erie, PA 16507-1729 | 2014-12-23 |
| 1194164442 | Cornell Abraxas Group, Inc | Psychiatric Residential Treatment Facility | 165 Abraxas Rd, Marienville, PA 16239-0059 | 2013-06-20 |
| 1609153626 | Spirit of Gheel | Psychiatric Residential Treatment Facility | 10 Hollow Rd, Spring City, PA 19475 | 2011-11-04 |
| 1083905533 | Lakeview Neurocare Pennsylvania, Inc. | Psychiatric Residential Treatment Facility | 64 Woods Ln, Lewistown, PA 17044-2082 | 2011-05-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.