NPIMap

Organization Active NPI

Diakon Child, Family and Community Ministries

Doing business as Diakon Family Life Service

  • Community/Behavioral Health Agency
  • Montoursville, PA
National Provider Identifier
1467821207
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
331600 Issued in PA
Legal business name
DIAKON CHILD, FAMILY AND COMMUNITY MINISTRIES
Doing business as
Diakon Family Life Service
Practice address
241 Broad St
Montoursville, PA 17754-2283
Phone
(570) 433-7060
Fax
(570) 567-7184
NPI assigned
Sep 23, 2015
Last updated
Sep 23, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
DIAKON LUTHERAN SOCIAL MINISTRIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

Name
Scott D Habecker
Title
Executive Vice President/Coo/Fco
Phone
(610) 682-1262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 331600 PA Primary

Addresses

Primary practice location

241 Broad St
Montoursville, PA 17754-2283

Mailing address

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

Other names 1

  • Diakon Family Life Service Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141215000318 PA Part B Supplier - Clinic/Group Practice 8820310279 Receives reassigned benefits from 11 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lewisburg, PA; Mechanicsburg, PA; Montoursville, PA; New Bloomfield, PA; Williamsport, PA

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Diakon Child Family Community Ministries26 organizations share this tax ID, including this one
Part of
Locust Grove Retirement

Other organizations with this tax ID 25

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

View all 25

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/diakon/r4/

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1467821207",
    "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": "241 BROAD ST",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177542283",
            "telephone_number": "570-433-7060",
            "fax_number": "570-567-7184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAKON CHILD, FAMILY AND COMMUNITY MINISTRIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIAKON LUTHERAN SOCIAL MINISTRIES",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "HABECKER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT/COO/FCO",
        "authorized_official_telephone_number": "610-682-1262"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "331600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diakon Family Life Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montoursville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.