Provider Demographics
NPI:1245760743
Name:PENNSYLVANIA PSYCHIATRIC INSTITUTE
Entity Type:Organization
Organization Name:PENNSYLVANIA PSYCHIATRIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-782-4742
Mailing Address - Street 1:2501 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1904
Mailing Address - Country:US
Mailing Address - Phone:717-782-4742
Mailing Address - Fax:
Practice Address - Street 1:401 DIVISION ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-2058
Practice Address - Country:US
Practice Address - Phone:717-782-4349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty