NPIMap

Organization Active NPI

Perseus House, Inc

  • Community/Behavioral Health Agency
  • Erie, PA
National Provider Identifier
1255480174
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
407390 Issued in PA
Legal business name
PERSEUS HOUSE, INC
Practice address
1510 State St
Erie, PA 16501-2220
Phone
(814) 480-5905
Fax
(814) 456-4229
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Mark Amendola
Title
Executive Director
Phone
(814) 480-5956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 407390 PA Primary

Addresses

Primary practice location

1510 State St
Erie, PA 16501-2220

Mailing address

1511 Peach St
Erie, PA 16501-2104
Phone (814) 480-5911

Other identifiers 1

IdentifierTypeStateIssuer
407390MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Perseus House Inc7 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.

Locations

1510 State St
Erie, PA 16501
Phone (814) 480-5900

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1255480174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012104",
            "telephone_number": "814-480-5911",
            "fax_number": "814-454-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012220",
            "telephone_number": "814-480-5905",
            "fax_number": "814-456-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSEUS HOUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "AMENDOLA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "814-480-5956"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "407390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407390",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.