NPIMap

Organization Active NPI

Philhaven

Doing business as WellSpan Philhaven

  • Public Health or Welfare Agency
  • Lebanon, PA
National Provider Identifier
1952526089
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
PHILHAVEN
Doing business as
WellSpan Philhaven
Practice address
209 Hathaway Park
Lebanon, PA 17042-6163
Phone
(717) 274-3363
NPI assigned
Apr 16, 2007
Last updated
Mar 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Mantha Kotsalos
Title
VP & President Philhaven
Phone
(717) 270-2423

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

209 Hathaway Park
Lebanon, PA 17042-6163

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (800) 932-0359

Other practice location 2

1101 Edgar St
York, PA 17403-2862
Phone (800) 673-2496

Other identifiers 3

IdentifierTypeStateIssuer
1007720000170MedicaidPA
1007720000124MedicaidPA
1007720000151MedicaidPA

Other names 2

  • WellSpan Philhaven Doing business as
  • WellSpan Philhaven Crisis Intervention Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

National Provider Directory

National Provider Directory
Tax ID family
Philhaven Hospital Psyc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

209 Hathaway Park
Lebanon, PA 17042
Phone (717) 274-3363

1101 Edgar St
York, PA 17403
Phone (717) 812-4602

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1952526089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HATHAWAY PARK",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426163",
            "telephone_number": "717-274-3363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "800-932-0359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Edgar St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174032862",
            "country_code": "US",
            "telephone_number": "800-673-2496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHILHAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "KOTSALOS",
        "authorized_official_first_name": "MANTHA",
        "authorized_official_title_or_position": "VP & PRESIDENT PHILHAVEN",
        "authorized_official_telephone_number": "717-270-2423"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000170",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000124",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000151",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WellSpan Philhaven",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellSpan Philhaven",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellSpan Philhaven Crisis Intervention",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.