NPIMap

Organization Active NPI

Perseus House Inc

  • Psychiatric Residential Treatment Facility
  • MC Kean, PA
National Provider Identifier
1073785697
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
435250 Issued in PA
Legal business name
PERSEUS HOUSE INC
Practice address
6101 West Rd
MC Kean, PA 16426-1123
Phone
(814) 476-7514
Fax
(814) 476-7417
NPI assigned
Mar 25, 2008
Organization subpart
Yes
Parent organization
PERSEUS HOUSE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mark A Amendola
Title
Executive Director
Phone
(814) 480-5956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 435250 PA Primary

Addresses

Primary practice location

6101 West Rd
MC Kean, PA 16426-1123

Mailing address

1511 Peach St
Erie, PA 16501-2104
Phone (814) 480-5911

Other identifiers 1

IdentifierTypeStateIssuer
1007713900038MedicaidPA

Other names 1

  • Brighter Horizons Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Perseus House Inc7 organizations share this tax ID, including this one
Part of
Perseus House Inc

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6101 West Rd
Mc Kean, PA 16426
Phone (814) 476-7514

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1073785697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012104",
            "telephone_number": "814-480-5911",
            "fax_number": "814-454-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 WEST RD",
            "city": "MC KEAN",
            "state": "PA",
            "postal_code": "164261123",
            "telephone_number": "814-476-7514",
            "fax_number": "814-476-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSEUS HOUSE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERSEUS HOUSE INC",
        "enumeration_date": "2008-03-25",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "AMENDOLA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "814-480-5956",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "PA",
            "license": "435250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007713900038",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brighter Horizons",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brighter Horizons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in MC Kean, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.