NPIMap

Organization Active NPI

Friendship House

  • Adolescent and Children Mental Health Clinic/Center
  • Scranton, PA
National Provider Identifier
1952373250
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
225110 Issued in PA
Legal business name
FRIENDSHIP HOUSE
Practice address
1509 Maple St
Scranton, PA 18505-2707
Phone
(570) 342-8305
Fax
(570) 344-1172
NPI assigned
Feb 2, 2006
Last updated
Dec 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Authorized official

Name
Ms. Christine A. Gilroy, CPA
Title
Executive Vice President
Phone
(570) 342-8305

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X 225110 PA Primary
Foster Care Agency 253J00000X 109710 PA

Addresses

Primary practice location

1509 Maple St
Scranton, PA 18505-2707

Mailing address

1509 Maple St
Scranton, PA 18505-2707
Phone (570) 342-8305

Other identifiers 2

IdentifierTypeStateIssuer
100759410-0018MedicaidPA
100759410-0048MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190124000695 PA Part B Supplier - Clinic/Group Practice 6002153376 Receives reassigned benefits from 4 practitioners
Practice locations: Carbondale, PA; Mayfield, PA; Scranton, PA

National Provider Directory

National Provider Directory

Locations

30-32 N Main St
Carbondale, PA 18407
Phone (570) 242-2271

1509 Maple St
Scranton, PA 18505
Phone (570) 342-8305

415 Biden St
Scranton, PA 18503
Phone (570) 344-1115

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513728000000",
    "number": "1952373250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 MAPLE ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052707",
            "telephone_number": "570-342-8305",
            "fax_number": "570-344-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 MAPLE ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052707",
            "telephone_number": "570-342-8305",
            "fax_number": "570-344-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDSHIP HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2017-12-20",
        "status": "A",
        "authorized_official_last_name": "GILROY",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "570-342-8305",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "225110",
            "primary": true
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "PA",
            "license": "109710",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100759410-0018",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100759410-0048",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.