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Martha Lloyd CRF Exchange Street

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Troy, PA

NPI 1962666446 · NPPES record last updated Jul 15, 2008

Key facts

NPI
1962666446
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
MARTHA LLOYD CRF EXCHANGE STREET
Practice address
210 Exchange St
Troy, PA 16947-1106
Phone
(570) 297-2185
Fax
(570) 297-1019
NPI assigned
Jul 15, 2008
Organization subpart
No

Authorized official

Name
William Miller
Title
CRF Director
Phone
(570) 297-2185

Corporate family (same tax ID) 34

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

View all 34

National Provider Directory

Tax ID family
Martha Lloyd Community Residential Facility (35 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

210 Exchange St
Troy, PA 16947-1106

Mailing address

190 W Main St
Troy, PA 16947-1131
Phone (570) 297-2185

Other identifiers

IdentifierTypeStateIssuer
1015544810050MedicaidPA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 15, 2008.

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1962666446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 W MAIN ST",
            "city": "TROY",
            "state": "PA",
            "postal_code": "169471131",
            "telephone_number": "570-297-2185",
            "fax_number": "570-297-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 EXCHANGE ST",
            "city": "TROY",
            "state": "PA",
            "postal_code": "169471106",
            "telephone_number": "570-297-2185",
            "fax_number": "570-297-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA LLOYD CRF EXCHANGE STREET",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CRF DIRECTOR",
        "authorized_official_telephone_number": "570-297-2185"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015544810050",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, PA

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