Provider Demographics
NPI:1386820017
Name:PENNSYLVANIA PSYCHIATRIC INSTITUTE
Entity Type:Organization
Organization Name:PENNSYLVANIA PSYCHIATRIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:FEEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-782-4742
Mailing Address - Street 1:PO BOX 826929
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-1904
Mailing Address - Country:US
Mailing Address - Phone:717-782-4783
Mailing Address - Fax:717-782-2351
Practice Address - Street 1:2501 N 3RD ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1904
Practice Address - Country:US
Practice Address - Phone:717-782-4783
Practice Address - Fax:717-782-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2318OtherHIGHMARK
PA102096380 0001Medicaid
PA394000OtherCAPITAL BLUE CROSS
PA1569499OtherGATEWAY MEDIASSURED
PA1569499OtherGATEWAY MEDIASSURED