NPIMap

Organization Active NPI

Dickinson Center, Inc

  • Community/Behavioral Health Agency
  • Ridgway, PA
National Provider Identifier
1750418554
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DICKINSON CENTER, INC
Practice address
43 Servidea
Ridgway, PA 15853
Phone
(814) 772-2005
Fax
(814) 776-0234
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Authorized official

Name
Jack A Groga
Title
Ceo
Phone
(814) 776-2145

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X PA
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

43 Servidea
Ridgway, PA 15853

Mailing address

43 Servidea Drive
Ridgway, PA 15853
Phone (814) 776-2145

Other names 1

  • Dickinson Mental Health Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Dickinson Center Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1750418554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 SERVIDEA DRIVE",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "15853",
            "telephone_number": "814-776-2145",
            "fax_number": "814-776-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 SERVIDEA",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "15853",
            "telephone_number": "814-772-2005",
            "fax_number": "814-776-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKINSON CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "GROGA",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-776-2145"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dickinson Mental Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ridgway, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.