NPIMap

Organization Active NPI

Warren General Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Warren, PA
National Provider Identifier
1376497362
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
Legal business name
WARREN GENERAL HOSPITAL
Practice address
2 W Crescent Park RM 3D
Warren, PA 16365-2111
Phone
(814) 723-7580
NPI assigned
Feb 25, 2026
Last updated
Sep 9, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
WARREN GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Lisa M Ristau
Title
Dir of Patient Accts
Phone
(814) 723-4973

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X Primary
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

2 W Crescent Park RM 3D
Warren, PA 16365-2111

Mailing address

2 W Crescent Park RM 3D
Warren, PA 16365-2111
Phone (814) 406-0035

Other names 1

  • Detox Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250918000042 PA Part A Provider - Critical Access Hospital 4880501402 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Youngsville, PA; Warren, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376497362. Details of each certification follow.

Hospital certification: CCN 391319

Legal name
WARREN GENERAL HOSPITAL
Doing business as
D/B/A LECOM HEALTH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 14, 2026
Last certification
Dec 29, 2025
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
2 W Crescent Park
Warren, PA 16365-2111
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
David E Martin Dental Clinic17 organizations share this tax ID, including this one
Part of
David E Martin Dental Clinic

Other organizations with this tax ID 16

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

View all 16

Locations

2 W Crescent Park
Rm 3D
Warren, PA 16365
Phone (814) 723-7580

Ownership & related parties

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Care Corporation of Warren Organization, Warren, PA Non-profit 5% Or Greater Direct Ownership Interest Apr 13, 1987 55%
Laurie Macdonald Individual Corporate OfficerChief Financial Officer May 15, 2023
Operational/Managerial ControlChief Financial Officer May 15, 2023
Allegheny Health Network Organization, Pittsburgh, PA Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 31, 2018 22.5%
Julia McTavish Individual OtherBoard Member Sep 1, 2018
Vikas Sacher Individual OtherBoard Member Jan 1, 2025
Lecom Health Affiliates, LLC Organization, Erie, PA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 31, 2018 22.5%
Highmark Health Organization, Pittsburgh, PA Non-profit 5% Or Greater Indirect Ownership Interest Aug 31, 2018 22.5%
Mason Tootell Individual OtherBoard Member Sep 1, 2018
Gwendolynn Scutella Individual OtherBoard Member Jul 1, 2024
Ahn-Lecom JV LLC Organization, Pittsburgh, PA Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 31, 2018 45%
Timothy Scott Stanton Individual OtherBoard Member Sep 1, 2018
Kathryn Carlson Individual Corporate OfficerChief Operating Officer Jul 1, 2025
Operational/Managerial ControlChief Operating Officer Jul 1, 2025
Brian Devine Individual OtherBoard Vice-Chairman Dec 19, 2023
Thad Turner Individual OtherBoard Chairman Sep 1, 2018
Timothy Bevevino Individual OtherBoard Secretary Sep 1, 2018
Millcreek Health System Organization, Erie, PA Non-profit 5% Or Greater Indirect Ownership Interest Aug 31, 2018 22.5%
Steven Inman Individual OtherBoard Member Dec 19, 2023
Karen Surkala Individual OtherBoard Member Apr 23, 2020
Trevor Olsen Individual OtherBoard Member Sep 1, 2018
Joseph J Maljovec Individual OtherBoard Member Jan 1, 2020
Whitney Morrison Individual OtherDirector of Credentialing Aug 8, 2022
Jasen Diley Individual OtherBoard Member Sep 1, 2018
Randall Scalise Individual OtherBoard Member Mar 2, 2022
Daniel W Grolemund Individual Corporate OfficerChief Executive Officer Jul 1, 2025
W-2 Managing EmployeeAd; Jul 1, 2025 100%
Operational/Managerial ControlChief Executive Officer Jul 1, 2025 100%

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 199

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 199

NPI Registry JSON

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

{
    "created_epoch": "1771977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1376497362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W CRESCENT PARK RM 3D",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-406-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W CRESCENT PARK RM 3D",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-723-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WARREN GENERAL HOSPITAL",
        "enumeration_date": "2026-02-25",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "RISTAU",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIR OF PATIENT ACCTS",
        "authorized_official_telephone_number": "814-723-4973"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Detox Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.