NPIMap

Organization Active NPI

Bethesda Family Services Foundation

  • Mental Illness Community Based Residential Treatment Facility
  • Sapulpa, OK
National Provider Identifier
1215255393
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
BETHESDA FAMILY SERVICES FOUNDATION
Practice address
1807 S Main St
Sapulpa, OK 74066-6531
Phone
(918) 224-6349
Fax
(918) 224-7951
NPI assigned
May 13, 2010
Last updated
Jan 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Authorized official

Name
Mr. Dominic P. Herbst, M.A, M.S.
Title
Founder, President
Phone
(570) 523-0605

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU

Addresses

Primary practice location

1807 S Main St
Sapulpa, OK 74066-6531

Mailing address

260 Reitz Blvd Ste 6
Lewisburg, PA 17837-9220
Phone (570) 523-0605

National Provider Directory

National Provider Directory
Tax ID family
Bethesda Family Services Foundation3 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.

Locations

260 Reitz Blvd
Ste 6
Lewisburg, PA 17837
Phone (570) 523-0605

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1215255393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 REITZ BLVD STE 6",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379220",
            "telephone_number": "570-523-0605",
            "fax_number": "570-523-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 S MAIN ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740666531",
            "telephone_number": "918-224-6349",
            "fax_number": "918-224-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA FAMILY SERVICES FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-13",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "HERBST",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "FOUNDER, PRESIDENT",
        "authorized_official_telephone_number": "570-523-0605",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A, M.S."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sapulpa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.