NPIMap

Organization Active NPI

Philhaven

Doing business as WellSpan Philhaven

  • Psychiatric Hospital
  • Lebanon, PA
National Provider Identifier
1972598076
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
PHILHAVEN
Doing business as
WellSpan Philhaven
Practice address
283 S Butler Rd
Lebanon, PA 17042-8939
Phone
(800) 932-0359
NPI assigned
Sep 14, 2005
Last updated
Jun 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

283 S Butler Rd
Lebanon, PA 17042-8939

Mailing address

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

Other practice location 1

315 W James St
Lancaster, PA 17603-2979
Phone (717) 270-2425

Other practice location 2

150 Roosevelt Ave
York, PA 17401-3380
Phone (717) 270-2425

Other practice location 3

125 Schneider Dr Ste B
Lebanon, PA 17046-4875
Phone (717) 376-1020

Other identifiers 5

IdentifierTypeStateIssuer
1007720000016MedicaidPA
1007720000174MedicaidPA
100772000-0175MedicaidPA
1007720000121MedicaidPA
318550OtherPACERTIFICATE OF COMPLIANCE LICENSE NUMBER

Other names 3

  • WellSpan Philhaven Doing business as
  • WellSpan Philhaven Inpatient Psychiatric Unit Other name
  • WellSpan Philhaven Private Psychiatric Hospital Other name

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031110000103 PA Part B Supplier - Clinic/Group Practice 8729991419 Receives reassigned benefits from 156 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, PA; Lancaster, PA; Ephrata, PA
O20100910000406 PA Part A Provider - Hospital 8729991419 3 other NPIs on this enrollment
Practice locations: York, PA; Lebanon, PA; Lancaster, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972598076. Details of each certification follow.

Hospital certification: CCN 394020

Legal name
PHILHAVEN
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1966
Last certification
Jun 10, 2015
Beds
103
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
May 11, 1949 in PA
Enrollment address
283 S Butler Rd
Lebanon, PA 17042-8939
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Philhaven

    dba WellSpan Philhaven

    • Psychiatry Physician
    • Lebanon, PA
    • NPI 1043316441

    8729991419

    Same PAC ID

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Philhaven HospitalCCN 394020 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

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

422 Cloverleaf Rd
Elizabethtown, PA 17022
Phone (717) 653-0731

344 N Reading Rd
Ephrata, PA 17522
Phone (717) 738-1125

354 N Reading Rd
Ephrata, PA 17522
Phone (717) 738-1125

2601 Herr St
Harrisburg, PA 17103
Phone (717) 230-9622

2717 N Front St
Harrisburg, PA 17110
Phone (717) 230-9622

1884 Rohrerstown Rd
Lancaster, PA 17601
Phone (717) 569-1166

1886 Rohrerstown Rd
Lancaster, PA 17601
Phone (717) 735-0800

2501 Oregon Pike
Ste 113
Lancaster, PA 17601
Phone (717) 735-1954

275 Hess Blvd
Ste 102
Lancaster, PA 17601
Phone (717) 399-7381

315 W James St
Lancaster, PA 17603
Phone (717) 509-0625

125 Schneider Dr
Lebanon, PA 17046
Phone (717) 270-2444

204 Hathaway Park
Lebanon, PA 17042
Phone (717) 274-9777

352 E Main St
Leola, PA 17540
Phone (717) 656-7036

283 Butler Rd
#550
Mount Gretna, PA 17064
Phone (717) 270-2451

1245 W Princess St
York, PA 17404
Phone (717) 845-2482

150 Roosevelt Ave
York, PA 17401
Phone (717) 356-5430

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Laura Buczkowski Individual Corporate OfficerSenior VP and Cfo Nov 30, 2020
W-2 Managing EmployeeSenior VP and Cfo Nov 30, 2020
Roxanna L Gapstur Individual OtherPresident, Wellspan Health Jan 2, 2019
Mantha Kotsalos Individual Corporate OfficerVP Behavioral Health Network Apr 23, 2024
W-2 Managing EmployeeVP Behavioral Health Network Apr 23, 2024
Robert Hoffman Individual Corporate Director Jan 1, 2021
Robert J Funk Individual Corporate Director Jan 1, 2021
Stephen a Lindsey Individual Corporate Director Jan 1, 2021
Christopher L Grant Individual Corporate Director Jan 1, 2021
Roger Zimmerman Individual Corporate Director Jan 1, 2021
Carrie Wilson Individual Corporate DirectorVice Chair Jan 1, 2021
Moniqua Acosta Individual Corporate OfficerChair Jan 1, 2021
Corporate Director Jul 1, 2013
Michael B Seim Individual Corporate DirectorEx-Officio Jan 1, 2021
Kimberly Shaun Kreider Umble Individual Corporate Director Jan 1, 2021
Wellspan Health Organization, York, PA Corporation, Non-profit Operational/Managerial Control Jan 1, 2016
Other Jan 1, 2016
Edward Joseph Tadajweski Individual Corporate Director Jan 1, 2021
James Stuccio Individual Corporate DirectorEx-Officio Jan 1, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

Practitioners & affiliated clinicians

Practitioners 252

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 252

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781222400000",
    "number": "1972598076",
    "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": "283 S BUTLER RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170428939",
            "telephone_number": "800-932-0359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W James St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176032979",
            "country_code": "US",
            "telephone_number": "717-270-2425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Roosevelt Ave",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174013380",
            "country_code": "US",
            "telephone_number": "717-270-2425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Schneider Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170464875",
            "country_code": "US",
            "telephone_number": "717-376-1020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHILHAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "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": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000016",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000174",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100772000-0175",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720000121",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE OF COMPLIANCE LICENSE NUMBER",
            "identifier": "318550",
            "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 Inpatient Psychiatric Unit",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WellSpan Philhaven Private Psychiatric Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.