NPIMap

Organization Active NPI

Deerfield Behavioral Health of Warren

Doing business as Deerfield Centers for Addictions Treatment

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tionesta, PA
National Provider Identifier
1740310184
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
627027 Issued in PA
Legal business name
DEERFIELD BEHAVIORAL HEALTH OF WARREN
Doing business as
Deerfield Centers for Addictions Treatment
Practice address
623 Elm St
Tionesta, PA 16353-8803
Phone
(888) 893-3228
NPI assigned
Mar 6, 2007
Last updated
Oct 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Authorized official

Name
Tina Cary
Title
Ex Dir
Phone
(814) 723-5545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 627027 PA Primary

Addresses

Primary practice location

623 Elm St
Tionesta, PA 16353-8803

Mailing address

1003 Pennsylvania Ave W FL 2
Warren, PA 16365-1876
Phone (814) 723-5545

Other identifiers 3

IdentifierTypeStateIssuer
330194OtherPAVALUE OPTIONS
0015930840012MedicaidPA
0828OtherPAHIGHMARK BLUE CROSS

Other names 1

  • Deerfield Centers for Addictions Treatment Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Deerfield Behavioral Health of Warren4 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.

Locations

623 Elm St
Tionesta, PA 16353
Phone (814) 723-1832

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1740310184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 PENNSYLVANIA AVE W FL 2",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163651876",
            "telephone_number": "814-723-5545",
            "fax_number": "814-362-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 ELM ST",
            "city": "TIONESTA",
            "state": "PA",
            "postal_code": "163538803",
            "telephone_number": "888-893-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERFIELD BEHAVIORAL HEALTH OF WARREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "CARY",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "EX DIR",
        "authorized_official_telephone_number": "814-723-5545"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "627027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "330194",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015930840012",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE CROSS",
            "identifier": "0828",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deerfield Centers for Addictions Treatment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Deerfield Centers for Addictions Treatment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tionesta, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.