Stoneycreek Residential, Inc

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

311620 Issued in PA

Legal business name

STONEYCREEK RESIDENTIAL, INC

Practice address

320 Eisenhower Blvd
Johnstown, PA 15905-3603

Phone

(814) 262-0025

NPI assigned

Mar 12, 2007

Organization subpart

No

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

Authorized official

Name

Larry J. Nulton, PHD

Title

President

Phone

(814) 262-0025

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659403806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EISENHOWER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 EISENHOWER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053603",
            "telephone_number": "814-262-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEYCREEK RESIDENTIAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NULTON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-262-0025",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "PA",
            "license": "311620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McCarey Stiehler
• Betsee Renee Stock, M.ED., NCC
• Leslie Ellen Stock, NP
• William Stodart, PT
• Melissa A Stoltz, M.S.
• Charles Wilbur Stotler, MD
• Gail A. Stotler, CRNP
• Seth Cameron Stouffer, PT
• Noelle Stratton, LSW
• Amber Dawn Strotman, RN

• Emotionally Disturbed Childrens' Residential Treatment Facility in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.