Eihab Human Services Pennsylvania Inc

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

EIHAB HUMAN SERVICES PENNSYLVANIA INC

Practice address

RR 6 Box 6543
Moscow, PA 18444-9665

Phone

(570) 309-6579

Fax

(570) 309-6362

NPI assigned

Oct 26, 2009

Last updated

Oct 26, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

EIHAB HUMAN SERVICES, INCAs reported in NPPES

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

Authorized official

Name

Jane Merolla

Title

Associate Executive Director

Phone

(570) 309-6579

Specialties & licenses 4

Addresses

Tax ID family

Eihab Human Services Pennsylvania Inc2 organizations share this tax ID, including this one

Part of

Eihab Human Services

Other organizations with this tax ID 1

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

• Eihab Human Services Pennsylvania, Inc.

  • Community/Behavioral Health Agency
  • Tunkhannock, PA
  • NPI 1871992883
  NPD tax ID

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256515200000",
    "number": "1255667242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16818 S CONDUIT AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114344899",
            "telephone_number": "718-276-6101",
            "fax_number": "718-276-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 6 BOX 6543",
            "city": "MOSCOW",
            "state": "PA",
            "postal_code": "184449665",
            "telephone_number": "570-309-6579",
            "fax_number": "570-309-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EIHAB HUMAN SERVICES PENNSYLVANIA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EIHAB HUMAN SERVICES, INC",
        "enumeration_date": "2009-10-26",
        "last_updated": "2009-10-26",
        "status": "A",
        "authorized_official_last_name": "MEROLLA",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "ASSOCIATE EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "570-309-6579"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Moscow, PA
• Providers in Moscow, PA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.