GOOD SHEPHERD YOUTH AND FAMILY SERVICES OF NEPA (LOURDESMONT BEHAVIORAL HEALTH SERVICES) NPI 1710103254

Community/Behavioral Health in Scranton, PA

NPI 1710103254 Organization Community/Behavioral Health

About GOOD SHEPHERD YOUTH AND FAMILY SERVICES OF NEPA (LOURDESMONT BEHAVIORAL HEALTH SERVICES)

Good Shepherd Youth And Family Services Of Nepa (lourdesmont Behavioral Health Services) is a provider established in Scranton, Pennsylvania specializing in community/behavioral health. The NPI number of Good Shepherd Youth And Family Services Of Nepa (lourdesmont Behavioral Health Services) is 1710103254 and was assigned on April 2007. The practitioner's primary taxonomy code is 251S00000X with license number 000204170 (PA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's former legal business name is Good Shepherd Youth And Family Services Of Nepa. The authorized official of this NPI record is Mr. Sal Santoli M.s. (Coo)

NPI

1710103254

Provider NameGOOD SHEPHERD YOUTH AND FAMILY SERVICES OF NEPA (LOURDESMONT BEHAVIORAL HEALTH SERVICES)
Provider Location Address1327 WYOMING AVE SCRANTON, PA 18509
Provider Mailing Address1327 WYOMING AVE SCRANTON, PA 18509
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameGOOD SHEPHERD YOUTH AND FAMILY SERVICES OF NEPA
Other Name TypeFormer Legal Business Name (4)
Enumeration Date04-17-2007
Last Update Date06-06-2014


Primary Taxonomy

Taxonomy Code251S00000X
ClassificationCommunity/Behavioral Health
TypeAgencies
License No.000204170
License StatePA
Taxonomy DescriptionA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Business Address

GOOD SHEPHERD YOUTH AND FAMILY SERVICES OF NEPA
1327 WYOMING AVE
SCRANTON, PA
ZIP 18509
Phone: (570) 702-8360
Fax: (570) 702-8623

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Mailing Address

GOOD SHEPHERD YOUTH AND FAMILY SERVICES OF NEPA
1327 WYOMING AVE
SCRANTON, PA
ZIP 18509
Phone: (570) 702-8360
Fax: (570) 702-8623



Authorized Official

Authorized Official NameMR. SAL SANTOLI M.S.
Authorized Official TitleCOO
Authorized Official Phone(570) 348-6100

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1251K00000XAgenciesPublic Health or Welfare000204170PANo

Taxonomy Description: Not Available

2261Q00000XAmbulatory Health Care FacilitiesClinic/Center000204170PANo

Taxonomy Description: a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

3261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)000204170PANo

Taxonomy Description: Not Available

4261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health000204170PANo

Taxonomy Description: an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1007283070011MEDICAID (05)PA

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1477689842GOOD SHEPHERD CORPORATION
Organization
Public Health or Welfare1327 WYOMING AVE
SCRANTON, PA 18509
(570) 702-8360
1003032558GOOD SHEPHERD CORPORATION
Organization
Case Management1327 WYOMING AVE
SCRANTON, PA 18509
(570) 702-8360
1851517304LOURDESMONT BEHAVIORAL HEALTH SERVICES
Organization
Case Management1327 WYOMING AVE
SCRANTON, PA 18509
(570) 702-8360
1235436551LOURDESMONT BEHAVIORAL HEALTH SERVICES
Organization
Community/Behavioral Health1327 WYOMING AVE
SCRANTON, PA 18509
(570) 702-8360

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.