Pennsylvania Department of Human Services

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES

Practice address

827 Oley Valley Rd
White Haven, PA 18661-3043

Phone

(570) 443-4266

Fax

(570) 443-4263

NPI assigned

Nov 28, 2005

Organization subpart

No

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

Authorized official

Name

Kathy Light

Title

Administrator

Phone

(717) 772-2518

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• White Haven Center Doing business as

Locations

Practitioners 2

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

• Jacinta Perez Rodriguez Wood, D.O.

  • Psychiatry Physician
  • Lewisburg, PA
  • NPI 1609892744
  NPD (past)
• Jay Willner, M.D.

  • Obstetrics & Gynecology Physician
  • Wilkes Barre, PA
  • NPI 1245259027

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1760465454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 OLEY VALLEY RD",
            "city": "WHITE HAVEN",
            "state": "PA",
            "postal_code": "186613043",
            "telephone_number": "570-443-4266",
            "fax_number": "570-443-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 OLEY VALLEY RD",
            "city": "WHITE HAVEN",
            "state": "PA",
            "postal_code": "186613043",
            "telephone_number": "570-443-4266",
            "fax_number": "570-443-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "717-772-2518"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100308518",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Haven Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "White Haven Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sylvia L Lafair, PHD
• Elaine Lehman, RN
• Briana A Lennon, LPC
• Lesley Ann McDermott
• Andrea Marie Patrick, PHARM.D. , R.PH.
• Kristen Pierce
• Cindi Rose Powell, M.ED, NCC, LPC
• Rite Aid of Pennsylvania LLC
• Harry P Saras, MD
• Asmita C Shah, M.D.

• Intellectual Disabilities Intermediate Care Facility in White Haven, PA
• Providers in White Haven, PA by specialty
• Intellectual Disabilities Intermediate Care Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.