NPIMap

Organization Active NPI

Glade Run Lutheran Services

  • Case Management Agency
  • Zelienople, PA
National Provider Identifier
1215074562
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
GLADE RUN LUTHERAN SERVICES
Practice address
70 Beaver Road
Zelienople, PA 16063-0070
Phone
(724) 452-4453
Fax
(724) 452-6576
NPI assigned
Jan 30, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Charles T. Lockwood, M.DIV.
Title
Executive Director
Phone
(724) 452-4453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary

Addresses

Primary practice location

70 Beaver Road
Zelienople, PA 16063-0070

Mailing address

P.O. Box 70
Zelienople, PA 16063-0070
Phone (724) 452-4453

Other identifiers 1

IdentifierTypeStateIssuer
100754254-0022MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Glade Run Lutheran Services12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215074562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 70",
            "city": "ZELIENOPLE",
            "state": "PA",
            "postal_code": "160630070",
            "telephone_number": "724-452-4453",
            "fax_number": "724-452-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BEAVER ROAD",
            "city": "ZELIENOPLE",
            "state": "PA",
            "postal_code": "160630070",
            "telephone_number": "724-452-4453",
            "fax_number": "724-452-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE RUN LUTHERAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOCKWOOD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "724-452-4453",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.DIV."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100754254-0022",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zelienople, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.