Alpine Springs Linesville, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

207020 Issued in PA

Legal business name

ALPINE SPRINGS LINESVILLE, LLC

Doing business as

Alpine Springs Rehabilitation and Recovery

Practice address

865 E Jamestown Rd
Jamestown, PA 16134-9505

Phone

(814) 818-0002

NPI assigned

Apr 15, 2016

Last updated

Jul 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Doug Datish

Title

Member

Phone

(814) 818-0002

Specialties & licenses 1

Addresses

Other names 1

• Alpine Springs Rehabilitation and Recovery Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563408000000",
    "number": "1275987240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 E JAMESTOWN RD",
            "city": "JAMESTOWN",
            "state": "PA",
            "postal_code": "161349505",
            "telephone_number": "814-818-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 E JAMESTOWN RD",
            "city": "JAMESTOWN",
            "state": "PA",
            "postal_code": "161349505",
            "telephone_number": "814-818-0002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "226 W Erie St",
            "address_purpose": "LOCATION",
            "city": "Linesville",
            "state": "PA",
            "postal_code": "164249214",
            "country_code": "US",
            "telephone_number": "814-818-0002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALPINE SPRINGS LINESVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2019-07-18",
        "status": "A",
        "authorized_official_last_name": "DATISH",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "814-818-0002"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "207020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpine Springs Rehabilitation and Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alpine Springs Rehabilitation and Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Betty Jean Bardella, MD
• Stacey Leigh Beise
• Full-Filled Nutrition, LLC
• Greblaw Inc (Jamestown Pharmacy)
• Jamestown Area School District

• Substance Abuse Rehabilitation Facility in Jamestown, PA
• Providers in Jamestown, PA by specialty
• Substance Abuse Rehabilitation Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.