Provider Demographics
NPI:1144228016
Name:CENTER FOR BEHAVIORAL HEALTH HA, LLC
Entity Type:Organization
Organization Name:CENTER FOR BEHAVIORAL HEALTH HA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-861-6000
Mailing Address - Street 1:6183 PASEO DEL NORTE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1155
Mailing Address - Country:US
Mailing Address - Phone:855-259-2288
Mailing Address - Fax:877-552-0439
Practice Address - Street 1:3601 N. PROGRESS AVE
Practice Address - Street 2:SUITE 100, 201
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110
Practice Address - Country:US
Practice Address - Phone:717-233-7290
Practice Address - Fax:717-233-5334
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACADIA HEALTHCARE COMPANY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-13
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
PA227069261Q00000X, 261QM2800X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No251B00000XAgenciesCase Management
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007554580005Medicaid
PA100755458005OtherCBHNP
PA1007554580005OtherCOMMUNITY CARE
PA369559OtherMAGELLAN BEHAVIORAL HEALT
PA328401A335755OtherVALUE OPTIONS
PA369559OtherMAGELLAN BEHAVIORAL HEALT