Organization Active NPI

Edgewater Psychiatric Center

  • Community/Behavioral Health Agency
  • Harrisburg, PA
National Provider Identifier
1720202948
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EDGEWATER PSYCHIATRIC CENTER
Practice address
1801 N Front St
Harrisburg, PA 17102-2241
Phone
(717) 441-3700
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Authorized official

Name
Matthew Zabolotny
Title
Corp Director of Business Ops
Phone
(717) 441-3700

Specialties & licenses 1

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

Addresses

Primary practice location

1801 N Front St
Harrisburg, PA 17102-2241

Mailing address

1320 Linglestown Rd
Harrisburg, PA 17110-2822

Other identifiers 1

IdentifierTypeStateIssuer
1007457920012MedicaidPA

National Provider Directory

National Provider Directory

Locations

295 State Dr
Elizabethville, PA 17023
Phone (717) 827-4636

2421 N Front St
Harrisburg, PA 17110
Phone (717) 238-7662

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1720202948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 LINGLESTOWN RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171102822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171022241",
            "telephone_number": "717-441-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWATER PSYCHIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "ZABOLOTNY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CORP DIRECTOR OF BUSINESS OPS",
        "authorized_official_telephone_number": "717-441-3700"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007457920012",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.