NPIMap

Organization Active NPI

Main Line Treatment, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Paoli, PA
National Provider Identifier
1083172803
Registry record updated Mar 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MAIN LINE TREATMENT, LLC
Doing business as
Main Line Treatment, LLC
Practice address
1410 Russell Rd Ste 205
Paoli, PA 19301-1200
Phone
(610) 407-4666
Fax
(610) 407-4666
NPI assigned
Mar 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2019

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

Authorized official

Name
Mr. Timothy P Boyle, LPC
Title
President
Phone
(610) 416-9444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1410 Russell Rd Ste 205
Paoli, PA 19301-1200

Mailing address

355 Highland Ave
Berwyn, PA 19312-1600
Phone (610) 416-9444

Other names 1

  • Main Line Treatment, LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552694400000",
    "number": "1083172803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 HIGHLAND AVE",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121600",
            "telephone_number": "610-416-9444",
            "fax_number": "610-407-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 RUSSELL RD STE 205",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011200",
            "telephone_number": "610-407-4666",
            "fax_number": "610-407-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE TREATMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-16",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-416-9444",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Line Treatment, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Main Line Treatment, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paoli, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2019; 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.