Edgewater Psychiatric Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EDGEWATER PSYCHIATRIC CENTER

Practice address

1100 S Cameron St
Harrisburg, PA 17104-2547

Phone

(717) 441-3700

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Matthew Zabolotny

Title

Corp Director of Business Ops

Phone

(717) 441-3700

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1356565576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 LINGLESTOWN RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171102822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S CAMERON ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171042547",
            "telephone_number": "717-441-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWATER PSYCHIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "ZABOLOTNY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CORP DIRECTOR OF BUSINESS OPS",
        "authorized_official_telephone_number": "717-441-3700"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007457920032",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eclat Home Health Care LLC
• Eclat Homecare Services LLC
• Edgar Counseling Services, Inc
• Jane H. Edgar, LCSW
• Elizabeth Edgell, CRNP
• Edgewater Psychiatric Center
• Edgewater Psychiatric Center
• Edgewater Psychiatric Center
• Edgewater Psychiatric Center
• Diane Edmond, MS, LPC

• Community/Behavioral Health Agency in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.