Project Starphish

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

444590 Issued in PA

Legal business name

PROJECT STARPHISH

Practice address

10987 Route 322
Shippenville, PA 16254-4837

Phone

(814) 661-2780

NPI assigned

May 31, 2013

Organization subpart

Yes

Parent organization

REIGNBOW ENTERPRISESAs reported in NPPES

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

Authorized official

Name

Ms. Leslie M Randolph, ADMINISTRATOR

Title

Administrator of Program Support

Phone

(814) 661-2780

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1831536853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162140771",
            "telephone_number": "814-661-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10987 ROUTE 322",
            "city": "SHIPPENVILLE",
            "state": "PA",
            "postal_code": "162544837",
            "telephone_number": "814-661-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT STARPHISH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REIGNBOW ENTERPRISES",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR OF PROGRAM SUPPORT",
        "authorized_official_telephone_number": "814-661-2780",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "444590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shippenville Elk Township Volunt
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• Shippenville Project Point of Light, Inc Dba Manno Therapeutic Service
• Nathanial Ryan Tyger, LPC

• Community/Behavioral Health Agency in Shippenville, PA
• Providers in Shippenville, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.