Angels Light Half Way House LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

ANGELS LIGHT HALF WAY HOUSE LLC

Practice address

201 Depot St
Youngwood, PA 15697-1617

Phone

(724) 635-3458

Fax

(724) 635-3463

NPI assigned

Aug 5, 2022

Last updated

Aug 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Keith Greenberg

Title

Business Manager

Phone

(914) 907-1246

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1982331310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEPOT ST",
            "city": "YOUNGWOOD",
            "state": "PA",
            "postal_code": "156971617",
            "telephone_number": "724-635-3458",
            "fax_number": "724-635-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DEPOT ST",
            "city": "YOUNGWOOD",
            "state": "PA",
            "postal_code": "156971617",
            "telephone_number": "724-635-3458",
            "fax_number": "724-635-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELS LIGHT HALF WAY HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-05",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "914-907-1246",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "OFFICE",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "201 Depot St",
            "city": "Youngwood",
            "state": "PA",
            "country_code": "US",
            "postal_code": "156971617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.