Organization Active NPI

Diakon Lutheran Social Ministries

Doing business as Diakon Family Life Services

  • Community/Behavioral Health Agency
  • New Bloomfield, PA
National Provider Identifier
1336205194
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DIAKON LUTHERAN SOCIAL MINISTRIES
Doing business as
Diakon Family Life Services
Practice address
Co New Bloomfield Borough Building
25 East McClure Street
New Bloomfield, PA 17068
Phone
(717) 795-0330
Fax
(717) 795-0407
NPI assigned
Dec 28, 2006
Last updated
Nov 8, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Authorized official

Name
Rita A. Rousseau
Title
Executive Director Cos
Phone
(717) 795-0368

Specialties & licenses 1

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

Addresses

Primary practice location

Co New Bloomfield Borough Building
25 East McClure Street
New Bloomfield, PA 17068

Mailing address

435 W 4TH St
Williamsport, PA 17701-6001
Phone (570) 322-7873

Other identifiers 1

IdentifierTypeStateIssuer
1007777400042MedicaidPA

Other names 1

  • Diakon Family Life Services Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1336205194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 W 4TH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177016001",
            "telephone_number": "570-322-7873",
            "fax_number": "570-322-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CO NEW BLOOMFIELD BOROUGH BUILDING",
            "address_2": "25 EAST MCCLURE STREET",
            "city": "NEW BLOOMFIELD",
            "state": "PA",
            "postal_code": "17068",
            "telephone_number": "717-795-0330",
            "fax_number": "717-795-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAKON LUTHERAN SOCIAL MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "ROUSSEAU",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR COS",
        "authorized_official_telephone_number": "717-795-0368"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007777400042",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diakon Family Life Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Bloomfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.