Provider Demographics
NPI:1033376256
Name:ADELPHOI VILLAGE, INC.
Entity Type:Organization
Organization Name:ADELPHOI VILLAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HERSHBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-804-7193
Mailing Address - Street 1:1119 VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-5201
Mailing Address - Country:US
Mailing Address - Phone:724-520-1111
Mailing Address - Fax:724-520-1878
Practice Address - Street 1:1119 VILLAGE WAY
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-5201
Practice Address - Country:US
Practice Address - Phone:724-520-1111
Practice Address - Fax:724-520-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA423910251K00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAA747622OtherVBH VENDOR ID - INDIANA
PAA953496OtherVBH VENDOR ID - FAYETTE
PA1007447300017Medicaid
PAA747622OtherVBH VENDOR ID - WESTMORELAND
PAA154172OtherVBH VENDOR ID - BEAVER
PAA979981OtherVBH VENDOR ID - MERCER
PAA882141OtherVBH VENDOR ID - CAMBRIA
PAMST-5000744730OtherCBHNP VENDOR ID - BLAIR/CUMBERLAND/PERRY
PAA747621OtherVBH VENDOR ID - GREENE
PAA747621OtherVBH VENDOR ID - WASHINGTON
PAA747622OtherVBH VENDOR ID - ARMSTRONG
PAA747622OtherVBH VENDOR ID - WESTMORELAND