NPIMap

Organization Active NPI

Lourdesmont Behavioral Health Services

  • Community/Behavioral Health Agency
  • Scranton, PA
National Provider Identifier
1710103254
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
000204170 Issued in PA
Legal business name
LOURDESMONT BEHAVIORAL HEALTH SERVICES
Practice address
1327 Wyoming Ave
Scranton, PA 18509-2861
Phone
(570) 702-8360
Fax
(570) 702-8623
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Authorized official

Name
Mr. Sal Santoli, M.S.
Title
Coo
Phone
(570) 348-6100

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 000204170 PA
Community/Behavioral Health Agency 251S00000X 000204170 PA Primary
Clinic/Center 261Q00000X 000204170 PA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 000204170 PA
Adolescent and Children Mental Health Clinic/Center 261QM0855X 000204170 PA

Addresses

Primary practice location

1327 Wyoming Ave
Scranton, PA 18509-2861

Mailing address

1327 Wyoming Ave
Scranton, PA 18509-2861
Phone (570) 702-8360

Other identifiers 1

IdentifierTypeStateIssuer
1007283070011MedicaidPA

Other names 1

  • Good Shepherd Youth and Family Services of Nepa Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Lourdesmont Behavioral Health Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402012800000",
    "number": "1710103254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 WYOMING AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185092861",
            "telephone_number": "570-702-8360",
            "fax_number": "570-702-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 WYOMING AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185092861",
            "telephone_number": "570-702-8360",
            "fax_number": "570-702-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOURDESMONT BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2014-06-06",
        "status": "A",
        "authorized_official_last_name": "SANTOLI",
        "authorized_official_first_name": "SAL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "570-348-6100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "PA",
            "license": "000204170",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "000204170",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "000204170",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "000204170",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "000204170",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007283070011",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Shepherd Youth and Family Services of Nepa",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; 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.