NPIMap

Organization Active NPI

Bethanna

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Southampton, PA
National Provider Identifier
1255407532
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
105330 Issued in PA
Legal business name
BETHANNA
Practice address
1030 2ND Street Pike
Southampton, PA 18966-3955
Phone
(215) 355-6500
Fax
(215) 355-8617
NPI assigned
Nov 28, 2006
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. Ronald Leigh Fritch
Title
Chief Financial Officer
Phone
(215) 355-6500

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 105330 PA Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 198540 PA
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 198530 PA
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 198520 PA
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 198510 PA

Addresses

Primary practice location

1030 2ND Street Pike
Southampton, PA 18966-3955

Mailing address

1030 2ND Street Pike
Southampton, PA 18966-3955
Phone (215) 355-6500

Other identifiers 1

IdentifierTypeStateIssuer
1007513410004MedicaidPA

Other names 1

  • Bethanna Bible and Missionary Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Bethanna7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255407532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 2ND STREET PIKE",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663955",
            "telephone_number": "215-355-6500",
            "fax_number": "215-355-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 2ND STREET PIKE",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663955",
            "telephone_number": "215-355-6500",
            "fax_number": "215-355-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRITCH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "215-355-6500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "PA",
            "license": "105330",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "PA",
            "license": "198540",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "PA",
            "license": "198530",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "PA",
            "license": "198520",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "PA",
            "license": "198510",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007513410004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethanna Bible and Missionary Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Southampton, 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.