NPIMap

Organization Active NPI

Edgewater Psychiatric Center

  • Community/Behavioral Health Agency
  • Harrisburg, PA
National Provider Identifier
1821267543
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EDGEWATER PSYCHIATRIC CENTER
Practice address
2421 N Front St
Harrisburg, PA 17110-1110
Phone
(717) 441-9565
NPI assigned
Feb 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Mr. Matthew Zabolotny
Title
Corp. Sr. Director of Business Ops.
Phone
(717) 441-9565

Specialties & licenses 1

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

Addresses

Primary practice location

2421 N Front St
Harrisburg, PA 17110-1110

Mailing address

1320 Linglestown Rd
Harrisburg, PA 17110-2822
Phone (717) 441-9565

Other identifiers 3

IdentifierTypeStateIssuer
1007457920002MedicaidPA
1007457920004MedicaidPA
1007457920005MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Edgewater Psychiatric Center4 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.

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1821267543",
    "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",
            "telephone_number": "717-441-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 N FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171101110",
            "telephone_number": "717-441-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWATER PSYCHIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "ZABOLOTNY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CORP. SR. DIRECTOR OF BUSINESS OPS.",
        "authorized_official_telephone_number": "717-441-9565",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007457920002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007457920004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007457920005",
            "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 Feb 27, 2008; 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.