NPIMap

Organization Active NPI

Adelphoi Village, Inc.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Latrobe, PA
National Provider Identifier
1841317575
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
423910 Issued in PA
Legal business name
ADELPHOI VILLAGE, INC.
Practice address
1119 Village Way
Latrobe, PA 15650-5201
Phone
(724) 520-1111
Fax
(724) 520-1878
NPI assigned
Mar 26, 2007
Last updated
Nov 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Authorized official

Name
Dana Maldet
Title
Director of Revenue Cycle Managemen
Phone
(724) 804-7159

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 423910 PA Primary
Forensic Psychiatry Physician 2084F0202X 423910 PA
Neurology Physician 2084N0400X 423910 PA
Neurodevelopmental Disabilities Physician 2084P0005X 423910 PA

Addresses

Primary practice location

1119 Village Way
Latrobe, PA 15650-5201

Mailing address

1119 Village Way
Latrobe, PA 15650-5201
Phone (724) 520-1111

Other identifiers 1

IdentifierTypeStateIssuer
1007447300019MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Adelphoi Village6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1841317575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 VILLAGE WAY",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156505201",
            "telephone_number": "724-520-1111",
            "fax_number": "724-520-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 VILLAGE WAY",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156505201",
            "telephone_number": "724-520-1111",
            "fax_number": "724-520-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADELPHOI VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "MALDET",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE MANAGEMEN",
        "authorized_official_telephone_number": "724-804-7159"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "PA",
            "license": "423910",
            "primary": true
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "PA",
            "license": "423910",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "423910",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "PA",
            "license": "423910",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007447300019",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latrobe, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.