Montgomery County Emergency Service Crisis Residential Program

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

103720 Issued in PA

Legal business name

MONTGOMERY COUNTY EMERGENCY SERVICE CRISIS RESIDENTIAL PROGRAM

Practice address

100 Eagleville Road
Acadia House
Eaglesville, PA 19403-1829

Phone

(610) 631-2480

Fax

(610) 631-2485

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

William Myers

Title

Ceo

Phone

(610) 279-6100

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Montg Co MH-Mr Emer SVC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Montgomery County Emergency Service, Inc.

  • Case Management Agency
  • Norristown, PA
  • NPI 1417373150
  NPD tax ID
• Montgomery County MH/Mr Emergency Service, Inc.

  • Ambulance
  • Norristown, PA
  • NPI 1043518582
  NPD tax ID

Locations

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1083744338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BEECH DRIVE",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194035421",
            "telephone_number": "610-279-6100",
            "fax_number": "610-279-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EAGLEVILLE ROAD",
            "address_2": "ACADIA HOUSE",
            "city": "EAGLESVILLE",
            "state": "PA",
            "postal_code": "194031829",
            "telephone_number": "610-631-2480",
            "fax_number": "610-631-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY EMERGENCY SERVICE CRISIS RESIDENTIAL PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "610-279-6100"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "PA",
            "license": "103720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007568020016",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.