NPIMap

Organization Active NPI

Philhaven

Doing business as WellSpan Philhaven

  • Clinic/Center
  • Lebanon, PA
National Provider Identifier
1508081639
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PHILHAVEN
Doing business as
WellSpan Philhaven
Practice address
283 S Butler Rd
Lebanon, PA 17042-8939
Phone
(717) 270-2425
NPI assigned
Apr 16, 2007
Last updated
Jun 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Authorized official

Name
Mantha Kotsalos
Title
VP & President Philhaven
Phone
(717) 270-2423

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

283 S Butler Rd
Lebanon, PA 17042-8939

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

1407 Williams Rd
York, PA 17402-9000
Phone (717) 894-5112

Other practice location 2

2501 Oregon Pike
Lancaster, PA 17601-4890
Phone (717) 279-2797

Other practice location 3

1315 Old Forge Rd
Lebanon, PA 17046-7951
Phone (717) 270-2425

Other practice location 4

780 Eden Rd
Lancaster, PA 17601-4275
Phone (717) 735-7770

Other practice location 5

125 Schneider Dr Ste B
Lebanon, PA 17046-4875
Phone (717) 270-2425

Other practice location 6

2124 Old Philadelphia Pike
Lancaster, PA 17602-3415
Phone (717) 676-7641

Other practice location 7

1000 S 8th St
Lebanon, PA 17042-6726
Phone (717) 874-9963

Other identifiers 7

IdentifierTypeStateIssuer
1007720000144MedicaidPA
1007720000150MedicaidPA
1007720000120MedicaidPA
1007720000147MedicaidPA
1007720000123MedicaidPA
1007720000148MedicaidPA
1007720000149MedicaidPA

Other names 3

  • WellSpan Philhaven Doing business as
  • WellSpan Philhaven Family Based Other name
  • WellSpan Philhaven Intensive Behavioral Health Services Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

National Provider Directory

National Provider Directory
Tax ID family
Philhaven Hosp15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

2124 Old Philadelphia Pike
Lancaster, PA 17602
Phone (717) 676-7641

2501 Oregon Pike
Lancaster, PA 17601
Phone (717) 735-1954

1000 S 8th St
Lebanon, PA 17042
Phone (717) 389-0368

Practitioners & affiliated clinicians

Practitioners 53

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.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781222400000",
    "number": "1508081639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 S BUTLER RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170428939",
            "telephone_number": "717-270-2425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1407 Williams Rd",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174029000",
            "country_code": "US",
            "telephone_number": "717-894-5112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 Oregon Pike",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176014890",
            "country_code": "US",
            "telephone_number": "717-279-2797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1315 Old Forge Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170467951",
            "country_code": "US",
            "telephone_number": "717-270-2425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "780 Eden Rd",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176014275",
            "country_code": "US",
            "telephone_number": "717-735-7770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Schneider Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170464875",
            "country_code": "US",
            "telephone_number": "717-270-2425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2124 Old Philadelphia Pike",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176023415",
            "country_code": "US",
            "telephone_number": "717-676-7641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 S 8th St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170426726",
            "country_code": "US",
            "telephone_number": "717-874-9963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHILHAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A",
        "authorized_official_last_name": "KOTSALOS",
        "authorized_official_first_name": "MANTHA",
        "authorized_official_title_or_position": "VP & PRESIDENT PHILHAVEN",
        "authorized_official_telephone_number": "717-270-2423"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000144",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000150",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000120",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000147",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000123",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000148",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000149",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WellSpan Philhaven",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellSpan Philhaven",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellSpan Philhaven Family Based",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WellSpan Philhaven Intensive Behavioral Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.