MARTHA LLOYD CRF BLOSS HOUSE (NPI# 1609030188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609030188 |
| Entity Type | Organization |
| Organization Name | MARTHA LLOYD CRF BLOSS HOUSE |
| Practice Address |
206 S Williamson Rd Blossburg PA 16912-1011 |
| Mailing Address |
190 W Main St Troy PA 16947-1131 |
| Practice Telephone | 5702972185 |
| Practice Fax Number | 5702971019 |
| Mailing Telephone | 5702972185 |
| Mailing Fax Number | 5702971019 |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2008-07-15 |
| Authorized Official Name | WILLIAM MILLER (DIRECTOR) |
| Authorized Official Telephone | 5702972185 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 216180 | PA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1015544810032 | 05 |
| Street Address |
206 S WILLIAMSON RD |
| City | BLOSSBURG |
| State | PA |
| Zip Code | 16912-1011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447326749 | Kathryn G Brodrick | Social Worker | 520 Ruah Street, Blossburg, PA 16912 | 2006-11-28 |
| 1790974822 | North Penn Comprehensive Health Services | Counselor | 520 Ruah Street, Blossburg, PA 16912 | 2007-10-15 |
| 1225155930 | North Penn Comprehensive Health Services | Counselor | 520 Ruah Street, Blossburg, PA 16912 | 2007-03-26 |
| 1467528810 | Anne Marie Anderegg | Social Worker | 520 Ruah Street, Blossburg, PA 16912 | 2006-11-28 |
| 1629431465 | Martha Lloyd Community Residential Facility | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 140 S Williamson Rd, Blossburg, PA 16912-1030 | 2016-03-30 |
| 1114965696 | Southern Tioga School District | Local Education Agency (LEA) | 241 Main St, Blossburg, PA 16912-1125 | 2006-06-04 |
| 1407919244 | Jeffrey Phillip Lemon | Pharmacist | 2 Riverside Plz, Blossburg, PA 16912-1137 | 2006-12-19 |
| 1154403038 | North Penn Comprehensive Health Services | Clinic/Center | 6 Riverside Plz, Blossburg Laurel Health Center, Blossburg, PA 16912-1137 | 2006-10-19 |
| 1083619415 | Bloss Pharmacy, Inc. | Pharmacy | 2 Riverside Plaza, Blossburg, PA 16912-1137 | 2005-06-13 |
| 1649709353 | Blaise Lachowicz | Pharmacist | 2 Riverside Plz, Blossburg, PA 16912-1137 | 2017-06-06 |
| Find all providers in zip 16912 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629431465 | Martha Lloyd Community Residential Facility | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 140 S Williamson Rd, Blossburg, PA 16912-1030 | 2016-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356940183 | Kenccid | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9350 Ashton Rd Rm 202, Philadelphia, PA 19114-7402 | 2020-10-22 |
| 1952908618 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 604 Glen Circle Dr, Tobyhanna, PA 18466-8300 | 2020-10-06 |
| 1598375305 | Impactful Human Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1055 Westlakes Dr Ste 3003, Berwyn, PA 19312-2410 | 2020-08-06 |
| 1356969679 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Genuardi Circle, West Chester, PA 19380 | 2020-07-13 |
| 1437775442 | The Arc of Crawford County, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 222 Chestnut St, Meadville, PA 16335-3407 | 2020-06-25 |
| 1568094142 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1768 Mcdonough Ave, Scranton, PA 18508-1566 | 2020-02-11 |
| 1114559267 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 336 Sheridan Ave, Clarks Summit, PA 18411-1458 | 2020-02-06 |
| 1619507332 | Above & Beyond Berks LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1007 Saylor Dr, Temple, PA 19560-9587 | 2020-01-22 |
| 1700425287 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 639 N South Turnpike Rd, Newfoundland, PA 18445-5032 | 2019-12-31 |
| 1891331120 | Gifted Hands Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1853 William Penn Way Ste 13, Lancaster, PA 17601-6713 | 2019-11-21 |
| Find all providers with the same taxonomy | ||||
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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.