NPIMap

Organization Active NPI

Martha Lloyd CRF Coppertree

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Troy, PA
National Provider Identifier
1528229804
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
202850 Issued in PA
Legal business name
MARTHA LLOYD CRF COPPERTREE
Practice address
20 Ballard St
Troy, PA 16947-1002
Phone
(570) 297-2185
Fax
(570) 297-1019
NPI assigned
Jun 19, 2008
Last updated
Jun 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
William Miller
Title
Director
Phone
(570) 297-2185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 202850 PA Primary

Addresses

Primary practice location

20 Ballard St
Troy, PA 16947-1002

Mailing address

190 W Main St
Troy, PA 16947-1131
Phone (570) 297-2185

Other identifiers 1

IdentifierTypeStateIssuer
1015544810023MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Martha Lloyd Community Residential Facility35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1528229804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 W MAIN ST",
            "city": "TROY",
            "state": "PA",
            "postal_code": "169471131",
            "telephone_number": "570-297-2185",
            "fax_number": "570-297-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 BALLARD ST",
            "city": "TROY",
            "state": "PA",
            "postal_code": "169471002",
            "telephone_number": "570-297-2185",
            "fax_number": "570-297-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA LLOYD CRF COPPERTREE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "570-297-2185"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "PA",
            "license": "202850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015544810023",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.