Colonial Park Intensive Outpatient Program, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

COLONIAL PARK INTENSIVE OUTPATIENT PROGRAM, LLC

Practice address

55 S Progress Ave
Harrisburg, PA 17109-4623

Phone

(717) 991-4755

Fax

(717) 724-5530

NPI assigned

Jun 1, 2017

Organization subpart

No

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

Authorized official

Name

John Laus

Title

Owner

Phone

(717) 991-4755

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508716800000",
    "number": "1861920936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 NW 3RD AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334442622",
            "telephone_number": "717-991-4755",
            "fax_number": "717-724-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 S PROGRESS AVE",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094623",
            "telephone_number": "717-991-4755",
            "fax_number": "717-724-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL PARK INTENSIVE OUTPATIENT PROGRAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-10-23",
        "status": "A",
        "authorized_official_last_name": "LAUS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-991-4755"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrett James Collins, DPT
• Marcia Collins, RPH
• Kaitlyn Nichole Colombo, CRNP
• Selena Colon
• Colonial Dental Group PC
• Colonial Park Pediatrics Associates
• Maya Blanc Colonna, LSW
• Tyler Anthony Colonno
• Columbia Cottage - Linglestown, LLC
• Comfort Care Home Care LLC

• Substance Use Disorder Rehabilitation Clinic/Center in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.