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GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA NPI 1477678258


NPI Information

NPI: 1477678258
Provider Name: GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA

Other Name: SPECIAL NEEDS 3

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
233 GEORGE JUNIOR ROAD
GROVE CITY, PA
ZIP 16127
Phone: (724) 458-9330
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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 1477678258. The provider is registered as an organization entity type.
The provider Other Name Is Special Needs 3.

The provider's business location address is:

233 GEORGE JUNIOR ROAD
GROVE CITY, PA
ZIP 16127
Phone: (724) 458-9330

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
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

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
10014522190020MEDICAIDPENNSYLVANIA

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

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