Active NPI
Edgewater Psychiatric Center
- Community/Behavioral Health Agency
- Harrisburg, PA
National Provider Identifier
1720202948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007457920012 | Medicaid | PA |
National Provider Directory
National Provider DirectoryLocations
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.