NPIMap

Organization Active NPI

Adelphoi Village, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Latrobe, PA
National Provider Identifier
1932226669
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
409300 Issued in PA
Legal business name
ADELPHOI VILLAGE, INC.
Practice address
1501 Ligonier St
Latrobe, PA 15650-2912
Phone
(724) 805-0161
Fax
(724) 805-0166
NPI assigned
Mar 26, 2007
Last updated
Nov 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 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 Managment
Phone
(724) 804-7159

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 409300 PA
Clinic/Center 261Q00000X 409300 PA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 409300 PA
Adolescent and Children Mental Health Clinic/Center 261QM0855X 409300 PA Primary
Community/Behavioral Health Agency 251S00000X 409300 PA

Addresses

Primary practice location

1501 Ligonier St
Latrobe, PA 15650-2912

Mailing address

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

Other practice location 1

310 Ligonier St
Latrobe, PA 15650-1420
Phone (724) 805-0161

Other identifiers 4

IdentifierTypeStateIssuer
100744730OtherCCBHO VENDOR NUMBER
A983178OtherVBH VENDOR ID
328824OtherVBH PROVIDER NUMBER
1007447300021MedicaidPA

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.

Locations

1501 Ligonier St
Latrobe, PA 15650
Phone (724) 804-7297

310 Ligonier St
Latrobe, PA 15650
Phone (724) 805-0161

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1604275200000",
    "number": "1932226669",
    "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": "1501 LIGONIER ST",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156502912",
            "telephone_number": "724-805-0161",
            "fax_number": "724-805-0166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Ligonier St",
            "address_purpose": "LOCATION",
            "city": "Latrobe",
            "state": "PA",
            "postal_code": "156501420",
            "country_code": "US",
            "telephone_number": "724-805-0161",
            "fax_number": "724-805-0166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADELPHOI VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "MALDET",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE MANAGMENT",
        "authorized_official_telephone_number": "724-804-7159"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "PA",
            "license": "409300",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "409300",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "409300",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "409300",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "409300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCBHO VENDOR NUMBER",
            "identifier": "100744730",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VBH VENDOR ID",
            "identifier": "A983178",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VBH PROVIDER NUMBER",
            "identifier": "328824",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007447300021",
            "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 2, 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.