GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA NPI 1134244858

NPI Information

NPI: 1134244858
Provider Name: GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA

Other Name: ZETA

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
120 W MAIN ST
GROVE CITY, PA
ZIP 16127
Phone: (724) 458-5315
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GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA is a community based residential treatment facility mental illness in Grove City, PA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA NPI is 1134244858. The provider is registered as an organization entity type.
The provider Other Name Is Zeta.

The provider's business location address is:

120 W MAIN ST
GROVE CITY, PA
ZIP 16127-222
Phone: (724) 458-5315

The provider's authorized official is Richard L. Losasso .
The authorized official title is Chief Executive Officer and has the following contact phone number (724) 458-9330.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0014522190047	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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